Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

Massimo Sartelli (1) , Gian L. Baiocchi , Salomone Di Saverio (2) , Francesco Ferrara , Francesco M. Labricciosa , Luca Ansaloni (3) , Federico Coccolini (4) , Deepak Vijayan , Ashraf Abbas , Hariscine K. Abongwa , John Agboola , Adamu Ahmed , Lali Akhmeteli , Nezih Akkapulu , Seckin Akkucuk , Fatih Altintoprak , Aurelia L. Andreiev , Dimitrios Anyfantakis , Boiko Atanasov , Miklosh Bala (5) , Dimitrios Balalis , Oussama Baraket , Giovanni Bellanova , Marcelo Beltran (6) , Renato Bessa Melo , Roberto Bini (7) , Konstantinos Bouliaris , Daniele Brunelli (8, 9) , Adrian Castillo , Marco Catani (10) , Asri Che Jusoh , Alain Chichom-Mefire (11) , Gianfranco Cocorullo , Raul Coimbra , Elif Colak , Silvia Costa , Koray Das , Samir Delibegovic , Zaza Demetrashvili , Isidoro Di Carlo , Nadezda Kiseleva , Tamer El Zalabany , Mario Faro , Margarida Ferreira (12) , Gustavo P. Fraga , Mahir Gachabayov , Wagih M. Ghnnam , Teresa Gimenez Maurel , Georgios Gkiokas , Carlos A. Gomes , Ewen Griffiths , Ali Guner , Sanjay Gupta , Andreas Hecker , Elcio S. Hirano , Adrien Hodonou , Martin Hutan , Orestis Ioannidis , Arda Isik , Georgy Ivakhov , Sumita Jain , Mantas Jokubauskas , Aleksandar Karamarkovic , Saila Kauhanen , Robin Kaushik , Alfie Kavalakat , Jakub Kenig , Vladimir Khokha , Desmond Khor , Dennis Kim , Jae I. Kim , Victor Kong , Konstantinos Lasithiotakis , Pedro Leao (13) , Miguel Leon (14) , Andrey Litvin , Varut Lohsiriwat , Eudaldo Lopez-Tomassetti Fernandez , Eftychios Lostoridis , James Maciel , Piotr Major , Ana Dimova , Dimitrios Manatakis , Athanasio Marinis , Aleix Martinez-Perez , Sanjay Marwah , Michael Mcfarlane , Cristian Mesina , Nickos Michalopoulos , Evangelos Misiakos , Ali Mohamedahmed , Radu Moldovanu , Giulia Montori , Raghuveer Mysore Narayana , Ionut Negoi , Ioannis Nikolopoulos , Giuseppe Novelli (15) , Viktors Novikovs , Iyiade Olaoye , Abdelkarim Omari , Carlos A. Ordonez , Mouaqit Ouadii , Zeynep Ozkan , Ajay Pal (16) , Gian M. Palini , Lars I. Partecke , Francesco Pata , Michal Pedziwiatr , Gerson A. Pereira Junior , Tadeja Pintar , Magdalena Pisarska , Cesar F. Ploneda-Valencia , Konstantinos Pouggouras , Vinod Prabhu , Padmakumar Ramakrishnapillai , Jean-Marc Regimbeau (17, 18) , Marianne Reitz , Daniel Rios-Cruz , Sten Saar , Boris Sakakushev , Charalampos Seretis , Alexander Sazhin , Vishal Shelat , Matej Skrovina , Dmitry Smirnov , Charalampos Spyropoulos , Marcin Strzalka , Peep Talving , Ricardo A. Teixeira Gonsaga , George Theobald , Gia Tomadze , Myftar Torba , Cristian Trana , Jan Ulrych , Mustafa Y. Uzunoglu , Alin Vasilescu , Savino Occhionorelli , Aurelien Venara (19, 20) , Andras Vereczkei , Nereo Vettoretto , Nutu Vlad , Maciej Waledziak , Tonguc U. Yilmaz , Kuo-Ching Yuan , Cui Yunfeng , Justas Zilinskas , Gerard Grelpois (18) , Fausto Catena

1 UNIMC - Università degli Studi di Macerata = University of Macerata
2 Maggiore Hospital
3 Hosp P Giovanni XXIII - Hospital Papa Giovanni XXIII
4 Rimini Infermi Hospital
5 Hadassah Hebrew University Medical Center [Jerusalem]
6 USERENA - Universidad de La Serena
7 LENS - European Laboratory for Non-Linear Spectroscopy
8 Dipartimento di scienze chimiche e geologiche
9 Istituto di Scienze del Mare
10 Natbrainlab
11 Regional Hospital, Limbe
12 Universidade do Porto = University of Porto
13 CIIMAR - Interdisciplinary Centre of Marine and Environmental Research [Matosinhos, Portugal]
14 Facultad de Ciencias Biologicas - Departamento de Microbiologıa y Genetica Molecular [Santiago, Chile]
15 Department of Public Health and Cell Biology, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
16 Biochemistry and Nutrition Discipline, Defence Food Research Laboratory, Mysore, India
17 Chirurgie digestive [CHU Amiens]
18 SSPC - Simplification des soins chez les patients complexes - UR UPJV 7518
19 UA - Université d'Angers
20 HIFIH - Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques

Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. Methods: This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. Results: A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. Conclusions: The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.

Domaines: Sciences du Vivant [q-bio]

Massimo Sartelli, Gian L. Baiocchi, Salomone Di Saverio, Francesco Ferrara, Francesco M. Labricciosa, et al.. Prospective Observational Study on acute Appendicitis Worldwide (POSAW). World Journal of Emergency Surgery, 2018, 13, ⟨10.1186/s13017-018-0179-0⟩. ⟨hal-03636193⟩