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Observational Study
. 2018 Apr 16:13:19.
doi: 10.1186/s13017-018-0179-0. eCollection 2018.

Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

Massimo Sartelli  1 , Gian L Baiocchi  2 , Salomone Di Saverio  3 , Francesco Ferrara  4 , Francesco M Labricciosa  5 , Luca Ansaloni  6 , Federico Coccolini  6 , Deepak Vijayan  7 , Ashraf Abbas  8 , Hariscine K Abongwa  9 , John Agboola  10 , Adamu Ahmed  11 , Lali Akhmeteli  12 , Nezih Akkapulu  13 , Seckin Akkucuk  14 , Fatih Altintoprak  15 , Aurelia L Andreiev  7 , Dimitrios Anyfantakis  16 , Boiko Atanasov  17 , Miklosh Bala  18 , Dimitrios Balalis  19 , Oussama Baraket  20 , Giovanni Bellanova  21 , Marcelo Beltran  22 , Renato Bessa Melo  23 , Roberto Bini  24 , Konstantinos Bouliaris  25 , Daniele Brunelli  26 , Adrian Castillo  27 , Marco Catani  28 , Asri Che Jusoh  29 , Alain Chichom-Mefire  30 , Gianfranco Cocorullo  31 , Raul Coimbra  32 , Elif Colak  33 , Silvia Costa  34 , Koray Das  35 , Samir Delibegovic  36 , Zaza Demetrashvili  37 , Isidoro Di Carlo  38 , Nadezda Kiseleva  39 , Tamer El Zalabany  40 , Mario Faro  41 , Margarida Ferreira  42 , Gustavo P Fraga  43 , Mahir Gachabayov  44 , Wagih M Ghnnam  45 , Teresa Giménez Maurel  46 , Georgios Gkiokas  47 , Carlos A Gomes  48 , Ewen Griffiths  49 , Ali Guner  50 , Sanjay Gupta  51 , Andreas Hecker  52 , Elcio S Hirano  43 , Adrien Hodonou  53 , Martin Hutan  54 , Orestis Ioannidis  55   56 , Arda Isik  57 , Georgy Ivakhov  58 , Sumita Jain  59 , Mantas Jokubauskas  60 , Aleksandar Karamarkovic  61 , Saila Kauhanen  62 , Robin Kaushik  51 , Alfie Kavalakat  63 , Jakub Kenig  64 , Vladimir Khokha  65 , Desmond Khor  66 , Dennis Kim  27 , Jae I Kim  67 , Victor Kong  68 , Konstantinos Lasithiotakis  69 , Pedro Leão  70 , Miguel Leon  71 , Andrey Litvin  72 , Varut Lohsiriwat  73 , Eudaldo López-Tomassetti Fernandez  74 , Eftychios Lostoridis  75 , James Maciel  27 , Piotr Major  76 , Ana Dimova  77 , Dimitrios Manatakis  78 , Athanasio Marinis  79 , Aleix Martinez-Perez  80 , Sanjay Marwah  81 , Michael McFarlane  82   83 , Cristian Mesina  84 , Michał Pędziwiatr  85 , Nickos Michalopoulos  86 , Evangelos Misiakos  87 , Ali Mohamedahmed  88 , Radu Moldovanu  89 , Giulia Montori  6 , Raghuveer Mysore Narayana  90 , Ionut Negoi  91 , Ioannis Nikolopoulos  92 , Giuseppe Novelli  93 , Viktors Novikovs  39 , Iyiade Olaoye  94 , Abdelkarim Omari  95 , Carlos A Ordoñez  96 , Mouaqit Ouadii  97 , Zeynep Ozkan  98 , Ajay Pal  99 , Gian M Palini  93 , Lars I Partecke  100 , Francesco Pata  101 , Michał Pędziwiatr  102 , Gerson A Pereira Júnior  103 , Tadeja Pintar  104 , Magdalena Pisarska  105 , Cesar F Ploneda-Valencia  106 , Konstantinos Pouggouras  75 , Vinod Prabhu  107 , Padmakumar Ramakrishnapillai  108 , Jean-Marc Regimbeau  109 , Marianne Reitz  110 , Daniel Rios-Cruz  111 , Sten Saar  112 , Boris Sakakushev  113 , Charalampos Seretis  114 , Alexander Sazhin  58 , Vishal Shelat  115 , Matej Skrovina  116 , Dmitry Smirnov  117 , Charalampos Spyropoulos  118 , Marcin Strzałka  119 , Peep Talving  112 , Ricardo A Teixeira Gonsaga  120 , George Theobald  7 , Gia Tomadze  121 , Myftar Torba  122 , Cristian Tranà  1 , Jan Ulrych  123 , Mustafa Y Uzunoğlu  14 , Alin Vasilescu  124 , Savino Occhionorelli  125 , Aurélien Venara  126 , Andras Vereczkei  127 , Nereo Vettoretto  128 , Nutu Vlad  124 , Maciej Walędziak  129 , Tonguç U Yilmaz  130 , Kuo-Ching Yuan  131 , Cui Yunfeng  132 , Justas Zilinskas  60 , Gérard Grelpois  109 , Fausto Catena  8
Affiliations
Observational Study

Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

Massimo Sartelli et al. World J Emerg Surg. .

Abstract

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.

Keywords: Acute appendicitis; Antibiotics; Diagnosis; Management; Surgery.

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Conflict of interest statement

The data was completely anonymized, and no patient or hospital information was collected in the database. The study protocol was approved by the board of the WSES, and the study was conducted under its supervision. The board of the WSES grants the proper ethical conduct of the study.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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