Right Illiac Fossa Treatment Audit

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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

Project timeline

Aug – Oct 2016Design of Protocol
30 Nov 2016National Research Collaborative Meeting
1 Dec 2016Protocol Launch
Dec 2016 – Feb 2017Recruitment of participating centres and local teams
Local audit registration and local pilots
Feb 2017Local audit registration deadline
Feb – July 2017Issue 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 2017Data validation protocol released
31 Aug 2017Data validation deadline, REDCap database locked
Aug – Dec 2017Data analysis and write up, conference abstract submissions and manuscript submission

Collaborator Documents
Collaborator Documents