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Background: There is significant variation in the management of patients with right iliac fossa (RIF) pain. Whilst laparoscopy has become first line in many units, the 2012 UK National Appendicitis Audit identified that a third of appendicectomies at that time were being performed using an open approach1. The results of this study were widely presented at local units and national meetings as well as being published in several journals.
New Guidelines: New guidelines published by the World Society of Emergency Surgery (WSES) in 20165 and the European Association of Endoscopic Surgeons (EAES) in 20156 provide an opportunity to close the loop on the 2012 audit and to re-audit the modern management of RIF pain.
Aim: The primary audit aim is to determine the laparoscopic appendicectomy rate in 2017. The secondary aim is to audit the normal appendicectomy rate. Variation in centres’ case mix may influence the normal appendicectomy rate. Patients can be stratified into low, medium, and high risk for appendicitis using the Alvarado or Appendicitis Inflammatory Response (AIR) scores (see Appendix E). Baseline variation will be addressed by adjustment using risk scoring.
Download RIFT protocol v4.2
|Aug – Oct 2016||Design of Protocol|
|30 Nov 2016||National Research Collaborative Meeting|
|1 Dec 2016||Protocol Launch|
|Dec 2016 – Feb 2017||Recruitment of participating centres and local teams|
|Local audit registration and local pilots|
|Feb 2017||Local audit registration deadline|
|Feb – July 2017||Issue of data collector REDCap logins|
|1st Data collection period March 13th – 26th 2017|
|2nd Data collection period April 24th – May 7th 2017|
|3rd Data collection period June 5th – 18th 2017|
|All patients should be followed-up to 30-days post index admission date|
|May 2017||Data validation protocol released|
|31 Aug 2017||Data validation deadline, REDCap database locked|
|Aug – Dec 2017||Data analysis and write up, conference abstract submissions and manuscript submission|