SP2.2 - A Retrospective Audit: Evaluating Changes in Negative Appendicectomy Rates from 2019 Before the Establishment of the Emergency General Surgery Service at a Tertiary Centre to 2022

Abstract Introduction and Aim Negative surgical exploration for suspected acute appendicitis remains prevalent, with a reported 20% rate in the UK Right Iliac Fossa Pain Treatment (RIFT) study. WSES guidelines endorse structured diagnostic pathways to decrease negative appendicectomy rates. To enhance acute surgery care, a dedicated Emergency General Surgery (EGS) service was established at a tertiary centre in 2020. This retrospective audit compares the negative appendicectomy rates between 2019 and 2022, therefore the main aim is to assess whether the introduction of a consultant-led EGS service influenced overall negative appendectomy rates. Methodology Appendicectomy numbers and histology results from 2019 and 2022 were analyzed. Histologically normal appendix cases were deemed negative appendicectomies, excluding unclear, other conditions, or missing reports. A retrospective review was conducted pre- and post-EGS service implementation. Results In 2019, 479 appendicectomies were audited, with a mean age of 34; 51% were female, and 20% were negative. Negative cases averaged 28 years, with 67% females. In 2022, 420 cases had a mean age of 40; 45% were female, 55% male, and negative rates reduced to 13%. Negative cases averaged 29 years, with 62% females. Conclusions Between 2019 and 2022, age groups were comparable. Negative cases in both years were more likely to be younger females compared to positive and total groups. The EGS service introduction demonstrated a notable decrease in negative appendectomy rates from 20% to 13% within two years, suggesting that consultant-led EGS services effectively reduce negative appendicectomy rates.