Appendicitis is the most common surgical emergency in the UK, associated with over 50,000 surgical procedures each year in England alone. However, 1 in 5 patients who undergo surgery to remove their appendix ultimately show no abnormalities when their appendix is examined under a microscope.
The UK has been shown to have suboptimal patient outcomes in cases of suspected appendicitis. This is evidenced by one of the highest rates of diagnostic error and unnecessary surgeries worldwide, often referred to as “operative overtreatment”. Operative overtreatment exposes patients to surgeries they don’t require, necessitating general anaesthesia, resulting in periods of postoperative pain and recovery, and, most importantly, subjecting them to avoidable harm from surgical complications. Approximately 7% of women and 23% of men develop complications after such surgeries, with surgical site infections (SSIs) being the most prevalent.
Patients who receive operative overtreatment also spend significantly more time in the hospital compared to those with uncomplicated appendicitis (non-perforated appendix), with an average hospital stay of 3.3 days versus 1.7 days. Furthermore, it is anticipated that unnecessary surgery has wider implications on patients’ quality of life, correct treatment pathways, and healthcare resources.
Improving diagnostic practice and correct care pathways could lead to an effective reduction in unnecessary surgery, improvements in patient reported quality of life outcomes and a reduced burden on healthcare services. We have developed a novel educational intervention to align current practice with the most recent empirical evidence. This could potentially make a significant positive impact on patient care nationally.