72249 - AIR score and CT scan utilization in all patients operated for acute appendicitis 2023 in a University Hospital

Introduction Acute appendicitis(AA) is a common surgical emergency. The diagnosis is confirmed by the pathologists in the PathologicalAnatomicDiagnoses (PAD). To get an indication for surgical treatment a combination of clinical assessment, laboratory tests and CT scan are used. Appendicitis Inflammatory Response (AIR) score can stratify the probability of AA as an alternative to or combined wirh imaging. The aim was to examine the use of AIR score and CT scan respectively. Method Retrospective observational study of all adult patients operated for AA in the Department of Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden during January-December 2023. AIR score and CT scan results were registered respectively and compaired with the results of PAD and peroperative diagnosis. Result Two-hundred-forty-nine patients (mean age 40 years) operated with laparoscopic/open surgery (91/9 %) for AA were included. PAD was analyzed in 98% and positive in 96% of these (AA, phleghmonous or gangenous +/- perforation) based on neutrophils in the appendiceal wall. CT scan was performed in 90% of all and in 98% of these AA were verified. AIR score stratification was documented in 60% of the 249. Peroperative diagnoses were precisely documented in the majority. Discussion The utilization of CT scan in almost everyone were unexpected. Few operations, even in the high probability of complicatedAA group, were done without CT scan. AIR score was documented/performed in only slightly more than half of the patients. The explorative laparoscopy was rarely used as an alternative to imaging. The most common explanations from our coworkers are the insufficient hospital beds and an unexperienced staff?