Evaluation of geographic variations in appendicectomy outcomes within Western Australia assessing the impact of surgical wait times and rate of negative appendicectomies in both urban and rural locations statewide

Abstract Purpose: Surgery wait times after diagnosis of appendicitis are an important factor influencing the success of a patient’s treatment. The proposed study will be a quantitative multicentre retrospective cohort design with the primary aim of assessing the difference between appendicectomy wait times between rural and urban hospitals in Western Australia and the effect of this on operative outcomes. Selected outcome measures will be examined by time from initial presentation at an Emergency Department to the patient being diagnosed and then time of diagnosis to surgery being performed. The secondary aim is to compare rates of negative appendicectomies between hospitals. Methods: Appendicectomy patients will be identified from Operating Room register by medical student data collectors, then each respective hospital’s Emergency Room data collection will subsequently be accessed to complete case report forms based on demographics and Clinical Findings, Pre-operative investigations and Management and follow up. Case report forms with >95% completeness will be accepted for pooled analysis. The expected duration of retrospective data collection will be 8 months. This includes the four two-week data collection periods and the subsequent one month follow up per collection period for possible postoperative complications. This study RGS6483 has received HREC approval by the Royal Perth Hospital HREC Ethics Committee, with a waiver of consent obtained. Dissemination of results: Data will be collected and stored online through a secure server running the Research Electronic Data Capture (REDCap) web application. No patient-identifiable data will be entered into the system. Results will subsequently be shared via scientific journal publication and presentation at relevant meetings.