SP2.05 What factors might influence negative outcomes after Emergency Appendicectomy – A Single Centre Study

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Abstract Aims To assess what factors influence negative outcomes in Emergency Appendicectomy. Methods All primary appendectomies undertaken within the emergency surgical service between 5/6/2023 to 21/3/2024 were included (n = 493). Data was extracted from the Electronic Patient Record. Results Wait time from admission (p=0.036) and booking (p=0.002) and pre-operative CRP (p<0.001) increase the rate of perforation at surgery in patients with CT confirming uncomplicated appendicitis, and pre-operative CRP maintained a significant independent influence (p<0.001). Median wait time from booking to theatre in patients with new perforation at surgery was 8.98 hours. Post-operative length of stay was significantly different when comparing Perforation at surgery (p<0.001), ASA grade (p<0.001) and pre-operative Albumin, (p=0.036). Post-operative CRP (p=0.008), ASA grade (p=0.049) and Time from admission to theatre (p<0.001) maintained significant independent influence. Readmissions were significantly higher in patients with perforation at surgery (p<0.001) but were lower in patients breaching NCEPOD 2a target (p=0.003), and those with increased wait time from admission (p=0.035) and booking (p=0.005) to theatre. Total peri-operative antibiotic therapy duration was significantly lower in patients being readmitted (p=0.003). Clavien-Dindo Complications were higher when comparing Perforation at surgery (p<0.001), Pre-operative CRP (p < 0.001), Post-operative antibiotic therapy duration (p<0.001) and total antibiotic therapy duration (p<0.001). Perforation at surgery maintained a significant independent influence (p=0.003). Conclusion Negative post-operative outcomes were influenced consistently by Perforation at Surgery, which itself is influenced by Wait time to theatre and Pre-operative CRP. Prioritization of patients with raised CRP and reduced wait times may improve outcomes.

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