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 Appendicectomy Audit identified that a third of appendicectomies at that time were being performed using an open approach. The results of this study were widely presented at local units and national meetings as well as being published in several journals.
New guidelines published by the World Society of Emergency Surgery (WSES) in 2016 and the alternative European Association of Endoscopic Surgeons (EAES, 2015) provide an opportunity to close the loop on the 2012 audit and to re-audit the modern management of RIF pain.
The primary aim of this audit 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. Baseline variation will be addressed by adjustment using risk scoring.
Key Points
Protocol
LSRG Registered Collaborators
Total collaborators = 167 | Audit registered = 82%
Hospital | Name | Grade | Audit Registered | Local Lead |
---|---|---|---|---|
Barnet Hospital | James Haddow | ST3+ | yes | |
Barnet Hospital | Scarlet Nazarian | CT | yes | Local lead |
Barnet Hospital | Nicholas Symons | ST3+ | yes | |
Basildon | Ines Silva | FY | yes | Local lead |
Basildon | Grigory Pankin | Med Student | yes | |
Basildon | Beghal Gurpreet | Med Student | yes | |
Basildon hospital | Hirel patel | FY | yes | |
Basildon Hospital | Adam Misky | FY | yes | |
Basildon Hospital | Nadeem Ashraf | Consultant | yes | |
Basildon Hospital | Andrew Busuttil | ST3+ | yes | |
Broomfield hospital | Osamah Niaz | CT | yes | Local lead |
Charing Cross | Michalis Charalambous | ST3+ | Local lead | |
Chelsea & Westminster Hospital | K.Yeung | ST3+ | Local lead | |
Chelsea and Westminster Hospital | George Malietzis | ST3+ | ||
Conquest and Eastbourne Hospital | Anthony Thaventhiran | ST3+ | yes | Local lead |
Conquest Hospital, St Leonards on Sea | D.Jenner | Consultant | yes | |
Croydon Hospital | Amelia Martin | Med Student | yes | |
Croydon Hospital | David Du | FY | yes | |
Croydon Hospital | Jessica Tan | CT | yes | |
Croydon Hospital | Paul Dent | ST3+ | yes | |
Croydon University Hospital | Nigel D'Souza | ST3+ | yes | |
Croydon University Hospital | Georgina Hicks | CT | yes | Local Lead |
Darent Valley Hospital | Nazrin Assaf | CT | yes | Local lead |
Dorset County Hospital | Zara Hayat | CT | Local lead | |
E.Tan@hotmail.co.uk | Lizzy Tan | FY | ||
Epsom & St Helier | Dr Mark Oakey | FY | yes | |
Epsom and St Helier NHS trust | Michael Murray | FY | yes | Local lead |
Frimley Park Hospital | Lalit | ST3+ | Local lead | |
Homerton | K. Theodoropoulou | ST3+ | yes | |
Homerton Hospital | Pedro Cunha | ST3+ | yes | |
Homerton Hospital | Dardan Popova | FY | yes | |
Homerton Hospital | Mary Venn | ST3+ | yes | Local lead |
Homerton Hospital | Abdul Quddus | Consultant | yes | |
Homerton University Hospital | Sarantos Kaptanis | ST3+ | yes | |
Homerton University Hospital | samuel dafydd rigby | FY | yes | |
Homerton University Hospital | Swathi Rajagopal | FY | ||
King George Hospital, Ilford | Sujay Shah | ST3+ | yes | Local lead |
King George Hospital, Ilford | Louise Murchison | CT | yes | |
King George Hospital, Ilford | James Graveston | CT | yes | |
King George Hospital, Ilford | Ed Balai | FY | yes | |
King George Hospital, Ilford | Aman Bhargava | Consultant | yes | |
King's College Hospital | Mili | FY | yes | |
King's College Hospital | Daniel Nash | FY | yes | |
kings college hospital | inez eiben | FY | yes | Local Lead |
Kingston | Jane Turner | ST3+ | yes | |
Kingston Hospital | Vera Tudyka | Consultant | yes | |
Kingston Hospital | Monika Rezacova | CT | yes | Local lead |
Leicester Royal Infirmary | Hilary West | ST3+ | yes | Local lead |
Lister Hosital, Stevenage | Emily Farrow | FY | yes | Local lead |
Lister Hospital, Stevanage | Andrew Barrie | FY | yes | |
Lister Hospital, Stevenage | Geraint Lloyd | Consultant | yes | |
Lister Hospital, Stevenage | Kathryn Kumar | FY | yes | |
Lister Hospital, Stevenage | Anoushka Neale | FY | yes | |
Lister Hospital, Stevenage | Dilek Taze | FY | yes | |
Lister Hospital, Stevenage | Siya Lodhia | FY | yes | |
Maidstone and Tunbridge Wells NHS Trust | Muhammad Rafaih Iqbal | ST3+ | yes | Local lead |
Medway Maritime Hospital | Constantine Halkias | ST3+ | yes | Local lead |
Medway Maritime Hospital | Evangelia Iosif | CT | yes | |
North Middelsex University Hospital | Manoj Nair | Consultant | yes | |
North Middlesex University Hospital | Martin Connor | CT | yes | |
North Middlesex University Hospital | Rory Callan | FY | yes | Local lead |
North Middlesex University Hospital | Subramaniam Guru Naidu | ST3+ | yes | |
Northwick Park | Josef Watfah | Consultant | yes | |
Northwick Park Hospital | Kapil Sahnan | ST3+ | yes | |
Northwick Park Hospital | Samuel Adegbola | ST3+ | yes | Local lead |
Northwick Park Hospital | Amish Acharya | CT | yes | |
Northwick Park Hospital | Abhiney Jain | CT | yes | |
Princess Royal University Hospital | Rehana Hafeez | ST3+ | yes | Local lead |
Princess Royal University Hospital, Orpington | Tarun Singhal | Consultant | yes | |
Queen Elizabeth Hospital, London | Midhat Siddiqui | Consultant | ||
Queen Elizabeth Hospital, London | Imran Chishti | ST3+ | ||
Queen Elizabeth Hospital, London | Julio Ayube-Brown | CT | ||
Queen Elizabeth Hospital, London | Zain Siddiqui | FY | ||
Queen Elizabeth Hospital, Woolwich | Victor Kung | ST3+ | yes | Local lead |
Queen Elizabeth Hospital, Woolwich | Joshua Tognarelli | FY | ||
Queen Elizabeth Hospital, Woolwich | Ashiv Patel | FY | ||
Queen Elizabeth Hospital, Woolwich | Beth Springate | FY | ||
Queen Elizabeth Hospital, Woolwich | Wenona Barnieh | FY | ||
Queen Elizabeth the Queen Mother Hospital | Mohamed A Rabie | ST3+ | yes | Local lead |
Queen Elizabeth the Queen Mother Hospital | Eda Yardimci | Med Student | yes | |
Queen Elizabeth the Queen Mother Hospital | Poonam Jani | FY | yes | |
Queen Elizabeth the Queen Mother Hospital | Laura Blake | CT | yes | |
Queen Elizabeth the Queen Mother Hospital | Sathyan Nagendram | CT | yes | |
Queen Elizabeth the Queen Mother Hospital | Mohamed Boshnaq | ST3+ | yes | |
Queens Hospital (Romford) | Shawmian Singagireson | FY | yes | Local lead |
Royal Free Hospital | Massimo Varcada | Consultant | yes | |
Royal Free Hospital | David Peprah | Med Student | yes | |
Royal Free Hospital | Angus Hann | ST3+ | yes | Local lead |
Royal London hospital | Maryam Alfa-Wali | ST3+ | yes | |
Royal London Hospital | Mohamed A Thaha | Consultant | ||
Royal London Hospital | Arti Garg | ST3+ | Local lead | |
Royal London Hospital | Ibnauf Suliman | ST3+ | ||
Royal London Hospital | Sadek Shahriar | ST3+ | ||
Royal London Hospital | Zara Al-Faham | FY | ||
Royal London Hospital | Alpa Morawala | CT | ||
Royal London Hospital | William English | CT | ||
Royal London Hospital | Tom Abbott | CT | ||
Royal London Hospital | Alexandra Osterberg | FY | ||
Royal Sussex County Hospital | James Cohen | FY | yes | Local lead |
Royal Sussex County Hospital, Brighton | Saad Rehman | CT | yes | |
Southampton General Hospital | Karan Rangarajan | CT | yes | Local lead |
St Helier | Edwin Evelyn-Rahr | FY | yes | |
St Helier | Hannah Smoker | FY | yes | |
St Helier Hospital | Dr Claire Nichols | FY | yes | Local lead |
St Helier Hospital | Thomas Hall | FY | yes | |
St Mary's Hospital | Rebecca Mersh | CT | yes | Local lead |
St Mary's Hospital, Paddington | James Kinross | Consultant | yes | |
St Mary's Hospital, Paddington | Andrea Frilling | Consultant | yes | |
St Peter's Hospital, Chertsey | Richard Newton | ST3+ | yes | Local lead |
St Thomas' | Dr Guy Stephens | FY | yes | Local lead |
St Thomas' Hospital | Amita Khasria | Med Student | yes | |
St Thomas' Hospital | Rahul Bagga | Med Student | yes | |
St Thomas' Hospital | Sarah Wheatstone | Consultant | yes | |
St Thomas' Hospital | james Gossage | Consultant | yes | |
St Thomas' Hospital | Pan Yidong | Med Student | ||
St Thomas' Hospital | Nipun Mundkur | Med Student | ||
St Thomas' Hospital | Dema Motter | Med Student | ||
St. George'Street Hospital, Tooting | Delia Toomey | CT | yes | Local lead |
St. George'Street Hospital, Tooting | Alex Rosinson | CT | yes | |
St. George'Street Hospital, Tooting | Ben Miller | CT | yes | |
St. George'Street Hospital, Tooting | Christina Fontaine | CT | yes | |
St. George'Street Hospital, Tooting | Rowland Storey | ST3+ | yes | |
St. George'Street Hospital, Tooting | Rowland Storey | ST3+ | yes | |
St. George'Street Hospital, Tooting | Nikhil Ladwa | ST3+ | yes | |
St. Mary's Hospital | Lisa Amani | Med Student | yes | |
The Whittington | Alexandra Kate Scholey | Med Student | yes | |
University College London Hospital | Sara Renshaw | CT | yes | |
University College London Hospital | Bibek Das | CT | yes | |
University College London Hospital | Danielle Franklin | FY | yes | Local lead |
University College London Hospital | Joseph Davidson | CT | yes | |
University College London Hospital | Uma Walters | FY | yes | |
Watford General Hospital | Dominic Townsend | FY | yes | |
Watford General Hospital | Walid Osama Mohamed | FY | yes | |
Watford General Hospital | Britain Baker | FY | yes | Local lead |
Watford General Hospital | Oliver Blackford | FY | yes | |
Watford General Hospital | James wakelam | CT | yes | |
Watford General Hospital | Sophie Bond | FY | yes | |
Watford General Hospital | Kajaluxy Ananthan | FY | yes | |
West Middlesex Hospital | Rebekah Williams | FY | yes | |
West Middlesex Hospital | Jack Garnham | FY | yes | |
West Middlesex Hospital | Henry Robb | FY | yes | |
West Middlesex Hospital | Jonathan Allington | FY | yes | |
West Middlesex Hospital | Louise Cloney | FY | yes | |
West Middlesex Hospital | Euan Strachan | FY | yes | |
West Middlesex University Hospital | Bubby Thava | Consultant | yes | |
West Middlesex University Hospital | Bhavik Patel | FY | yes | Local lead |
Weston general Hospital | Chiara Rossi | ST3+ | ||
Wexford General | Helen Earley | CT | yes | |
Wexford general hospital | Fiona Nolan | CT | yes | |
Wexford general hospital Ireland | Badreldin mohamed elbagir | CT | yes | |
Wexford General Hospital, Ireland. | Abdul Ahad | ST3+ | yes | Local lead |
Whipps Cross Hospital | Jia Choong | FY | Local lead | |
Whittington | Emily norman | FY | yes | |
Whittington | Samir Sahey | Med Student | yes | |
Whittington | Samuel Gunning | Med Student | yes | |
Whittington | Esther Nimako | Med Student | yes | |
Whittington | Darshni Pandya | Med Student | yes | |
Whittington Hospital | Tahira Mohamed | Med Student | yes | Local lead |
Whittington Hospital | Bryony Peiris | Med Student | yes | |
William Harvey Hospital | Nathan Hudson-Peacock | FY | yes | Local lead |
William Harvey Hospital | Pennylouise Hever | FY | yes | |
William Harvey Hospital | Mustafa Al-sheikh | ST3+ | yes | |
William Harvey Hospital | Caterina Clements | CT | yes | |
William Harvey Hospital | Amar Amayo | FY | yes | |
William Harvey Hospital | Rose Hartzenberg | FY | yes | |
William Harvey Hospital | Charles Bull | ST3+ | yes | |
Worthing Hospital | Madhusoodhana Hebbar | ST3+ | yes | Local lead |