WP7.17 - Routine Use of Validated Risk Prediction Model in the Management of Acute Appendicitis in a District General Hospital

Abstract Aim Acute appendicitis is the most common general surgery emergency in the UK. Currently, there is no optimal diagnostic pathway for managing the right iliac fossa (RIF) pain. The right iliac fossa pain treatment (RIFT) study group has previously performed an analysis of different risk prediction models to search for the most specific one and made a website (appy-risk.org) to calculate risk scores on presentation. We aimed to look into our practice in a DGH and see how compliant we are in documenting risk scores on presentation with acute RIF pain. Method A list of patients presenting with acute RIF pain to the surgical assessment unit in September was prepared. Admission clerking notes were reviewed from the electronic patient record to look for the documentation of the appendicitis risk score. Standard statistical packages were used for data analysis. Results A total of 95 patients were presented with RIF pain. Of them, 17 were excluded from the analysis for being over 45 years old. Of the remaining 78 patients' records, only 7 (8.97%) had appendicitis risk scores documented in the clerking notes. Conclusions The RIFT study highlighted a high normal appendicectomy rate (NAR) in the UK in comparison to other European countries. In our hospital, NAR was 9.74% in the first six months of 2023. We are in the process of implementing a pathway to manage acute RIF pain using a risk prediction model as advised by the RIFT group to reduce our NAR to less than 5%.