TPW 4.16 Complicated and Uncomplicated Appendicitis: A Cohort Study

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ID: 323954
2026
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Abstract
Abstract Aims Surgery is main treatment for acute-appendicitis (AA) & determined by its severity. Grading appendicitis can be challenging. Aim-of-study is to assess: outcomes of uncomplicated & complicated AA. Methods Cohort study was carried out from Jan’2020 to Jan’2026 at single-institution. Descriptive demography & outcomes were evaluated for complicated & uncomplicated AA including NHS-ledger-costing. Results Complicated-AA (n=584) Uncomplicated-AA (n=612) Mann-Whitney-U (p-value) Age(yrs) 42.3±0.9 33.1±0.9 <0.0001 Sex(M:F) 309:275 269:343 <0.05 BMI(kg/m2) 26.0±0.3 25.5±0.3 NS ASA 2±0.5 1±0.5 0.0003 WCC(x109/L) 13.9±0.2 12.1±0.2 <0.0001 CRP(mg/L) 110.9±4.5 44.7±2.4 <0.0001 Neut(x109/L) 11.4±0.2 9.5±0.2 <0.0001 Surgery(n) 476 421 <0.0001 Clinical(n) 133 NS USS-scan(n) 181 <0.001 CT-scan(n) 452 229 <0.0001 Op-time(mins) 88.9±1.6 66.2±1.2 <0.0001 Washout(n) 356 247 <0.0001 Drain(n) 154 15 <0.0001 LOS(days) 3±1.5 2±1 <0.0001 HPA-grade Stage-0 24 61 NS Stage-1 161 196 NS Stage-2 152 128 NS Stage-3 79 22 0.0017 Stage-4 63 13 0.0060 Inpatient-AB(days) 3±1.5 2±1 <0.0001 Post-op-AB(days) 5±3.5 2±2.5 <0.0001 Length(mm) 68.0±1.1 68.4±1.1 <0.0001 Diameter(mm) 11.7±0.3 10.0±0.2 <0.0001 Cost(£) 4232±207 2159±125 <0.0001 Conclusions Complicated-AA accounted for 48.8%: -presented with late severe appendicitis. Complicated-AA had more adverse features (e.g. raised-pre-operative-biomarkers). prolonged-antibiotic therapy & intra-operative-intervention (washout & drainage) than uncomplicated-AAs. Grading of appendicitis can be carried out pre-operatively: -clinically, -radiologically &-serologically & thereby aid management: early-antibiotics & surgery (complicated-AA operated as class-2-NCEPOD, uncomplicated-AA operated as class-3-NCEPOD).
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Authors M A Gok, N C McCarthy, K Riaz, H E Huguet, R U Aris, U A Khan
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.342
URL
https://doi.org/10.1093/bjs/znag087.342
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