- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04365491
European Society for Trauma and Emergency Surgery (ESTES) Cohort Study Snapshot Audit 2020 - Acute Appendicitis (SnapAppy)
Background Acute appendicitis is an extremely common surgical emergency. Traditionally, appendicitis has been managed surgically. Recently, however, variability in management of acute appendicitis has emerged, with some clinicians practising conservative, i.e. non-operative, management in selected patients. This high-quality pan-European, prospective audit will establish current practices and correlate them against outcomes.
Aim To explore differences in patient presentation, clinical course and outcomes for acute appendicitis across international clinical Centres to identify areas of practice variability in the presentation, management and complications of acute appendicitis.
Endpoints A three-stage data collection strategy will be used in this audit. There will be a 90 day prospective period for data collection during a six month window from September 2020 to end February 2021. Data collection will consist of collecting patient demographics, details of management (conservative vs surgical) and outcomes. Several outcomes measures will be used, including surgical mortality, morbidity (Clavien-Dindo Grade 2 and above) and length of hospital stay.
The data collection points are as follows:
90 Day Prospective Audit Collecting anytime during 6-month window:
- Demographics
- Operative technique
- Use of antibiotics
- Conservative vs surgical management
- Outcomes
All eligible patients will be followed up to 90 days from their admission
- Readmissions will be flagged and identified
- Complications within the 90 day period will be recorded
- Patients who have a complete data set at 90 days post presentation will be followed up to the 1-year mark • Incomplete data sets will be excluded from the study
Methods: This 90 day prospective audit will be performed across Europe from September 2020 to end February 2021., and will be co-ordinated by a designated committee of European Society of Trauma and Emergency Surgery. This will be preceded by a one-week, three-Centre pilot. Sites will be asked to pre-register for the audit and will be required to obtain appropriate regional or national approvals in advance of the enrolment date.
During the study period, all eligible patients with acute appendicitis will be recorded contemporaneously and followed-up through to 90 days from their admission. The audit will be performed using a standardised pre-determined protocol, instrument and a secure online database. The report of this audit will be prepared in accordance with guidelines set by the STROBE (strengthening the reporting of observational studies in epidemiology) statement for observational studies.
Discussion: This multi-centre, snapshot audit will be delivered by emergency surgeons and trainees in an coordinated and homogenous manner. The data obtained about areas of variability in provision or practice, and how this may impact upon outcomes, will serve to improve overall patient care as well as being hypothesis generating and inform areas needing future prospective study.
Study Overview
Status
Conditions
Study Type
Enrollment (Actual)
Contacts and Locations
Study Contact
- Name: Shahin Mohseni, MD, PhD
- Phone Number: +46 19 3030000
- Email: shahin.mohseni@oru.se
Study Contact Backup
- Name: Gary A Bass, MD, MS
- Phone Number: +353 83 4220287
- Email: garybassmd@gmail.com
Study Locations
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Dublin, Ireland
- Tallaght University Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
All hospitals/units performing general surgery are eligible to join this audit. No unit size or case throughput stipulations are made. Countries outside Europe can also participate in this audit.
All participating centres will register with the ESTES cohort study office and will be responsible for their own local approvals process prior to the start of the data collection period. Inclusion of data sets will be subject to local approval from participating clinical Centres.
Normal patient follow-up pathways can be utilised to obtain outcomes data. No additional visits or changes to normal follow-up should be made. However, local investigators should be proactive in identifying post-diagnosis. These may include reviewing the patient notes (paper and electronic) during admission and before discharge to note in-hospital complications, reviewing hospital systems to check for re-attendances or re-admissions, and reviewing post-operative radiology reports.
Description
6.4 Inclusion Criteria
Adult patients (≥16 years of age) admitted for:
Acute Appendicitis
Procedures which should be included:
- Appendectomy (open, laparoscopic or robotic)
- Diagnostic laparoscopy
Partial right hemicolectomy (for appendiceal mass or carcinoid tumour) Exclusion Criteria
- Mesenteric adenitis
- Ovarian pathology
Methods for identifying patients
Multiple methods may be used according to local circumstances/staffing:
- Daily review of emergency department (non-operative) and operating room lists
- Daily review of team handover sheets / emergency admission lists / ward lists
- Review of operating room logbooks
- Use of electronic systems to flag any readmissions of patients identified and treated
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of acute appendicitis
Time Frame: 3 months
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Incidence of acute appendicitis
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3 months
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Post-operative (or non-operative complications)
Time Frame: 90 days
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Complications related to disease and/or therapies within 90 post operative days
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90 days
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Length of post-operative stay in the hospital
Time Frame: 90 days
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90 days
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cost-analysis of treatment
Time Frame: 90 days
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90 days
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Re-admission within 90 postoperative days
Time Frame: 90 days
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90 days
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Number of participants with histopathological results, differences in age and clinical presentation
Time Frame: 90 days
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90 days
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Time to surgery
Time Frame: 90 days
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90 days
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Collaborators and Investigators
Sponsor
Investigators
- Study Director: Eanna J Ryan, MD MRCSI, St. Vincent's University Hospital, Dublin, Ireland
- Study Chair: Shahin Mohseni, MD, PhD, Örebro University Hospital, Sweden
- Principal Investigator: Gary A Bass, MD, MS, Dept Traumatology, Surgical Critical Care, University of Pennsylvania, Philadelphia, PA, USA
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- ESTESSnapshot2020Appendix
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Pooled Data will be published. Subgroup analyses by disease, technique or outcome variables may be presented, but no hospital-level or surgeon-level data will be published whereby an individual patient, unit or surgeon can be identified. If local investigators would like their own unit's raw data for benchmarking purposes and local presentation/discussion, this can be made available after the end of the study; however, it will not be possible to de-anonymise patient data stored in Smart-Trial, in strict compliance with GDPR.
The ESTES Cohort Studies Committee welcomes the use of the data for further research that benefits patients. Data sharing is subject to ESTES approval and appropriate safeguarding. Future sub-projects must comply with our policy of single corporate authorship e.g. "ESTES Cohort Studies Group". Authors' contributions will be highlighted in accordance with the recommendations for the conduct, reporting, editing, and publication of scholarly work in medical journals.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Appendicitis
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North Estonia Medical CentreTartu University HospitalRecruitingAcute Appendicitis | Appendicitis Acute | Appendicitis Perforated | Acute Appendicitis With Rupture | Appendicitis; Perforation | Acute Appendicitis Without Peritonitis | Acute Appendicitis With Appendix AbscessEstonia
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University of MichiganCompletedAppendicitis | Complicated Appendicitis | Perforated Appendicitis | Ruptured AppendicitisUnited States
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Johns Hopkins All Children's HospitalCompleted
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Pirogov Russian National Research Medical UniversityCompletedAcute Appendicitis | Acute Appendicitis With Rupture | Acute Appendicitis Without Peritonitis | Acute Appendicitis With PeritonitisRussian Federation
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Faculty Hospital Kralovske VinohradyCompletedAppendicitis | Appendicitis Acute | Retrocecal AppendicitisCzechia
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King Abdulaziz UniversityCompletedAppendicitis | Acute Appendicitis | Pathology | Appendicitis (Diagnosis)Saudi Arabia
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Mauro PoddaAssociazione Chirurghi Ospedalieri ItalianiCompletedAcute Appendicitis | Appendectomy | Antibiotic Therapy | Appendicitis RecurrentItaly