EP 697 Audit Report: Diagnosis-to-Operation Timing in Emergency Appendicectomy

Introduction

This audit evaluates compliance with WSES recommendations that emergency appendicectomy should occur within 24 hours of diagnosis. It also examines whether delays beyond 24 hours increase the risk of postoperative complications, using a cohort of 334 emergency cases.

Methods

All emergency Appendicectomy that were done between Feb and Aug 2025 were included (n=334). Duration from diagnosis to operation and postoperative complications were extracted. Delays were categorised as ≤24 hours or >24 hours. Statistical analysis included risk ratios and Fisher’s exact test.

Results

Timing Compliance49.1% of patients received surgery within 24 hours50.9% exceeded the 24-hour benchmark

Complication Rates≤24 hours: 13.4% complications (22/164)>24 hours: 7.1% complications (12/170)

Risk Ratio (RR) for >24 hours vs ≤24 hours = 0.53, suggesting no increased risk associated with delay. Fisher’s exact test p=0.069.

Discussion

Although half of patients exceeded the WSES 24-hour target, delays did not correspond to increased postoperative complications. Earlier surgery appears to be prioritised for clinically severe cases, causing higher complication rates in the faster-operated group.

Conclusion

There is no evidence that delays beyond 24 hours increase complications. However, compliance with WSES targets should be improved as a performance standard.