Emerging Role of postoperative complication tracking in the Diagnosis of acute appendicitis
DOI:
https://doi.org/10.5281/zenodo.22813470Keywords:
acute appendicitis, postoperative complications, diagnostic accuracy, surgical audit, negative appendectomyAbstract
Background: Diagnostic pathways for acute appendicitis, built on clinical scoring, imaging, and inflammatory biomarkers, remain imperfect, producing both missed and negative diagnoses despite decades of refinement [1,10].
Objective: This review synthesizes evidence on how systematic postoperative complication tracking, developed originally for surgical quality audit, feeds back into and refines the diagnostic process for acute appendicitis.
Methods: We synthesized clinical scoring validation studies, imaging and biomarker accuracy reviews, randomized trials of non-operative management, and national audit and registry reports using structured complication-tracking frameworks such as NSQIP and the Clavien-Dindo classification [12,11].
Findings: Complication data linked to diagnostic pathway intervals show that delayed or equivocal diagnosis is associated with higher rates of surgical site infection, abscess, and reoperation [19,17], negative appendectomy rates have fallen substantially with routine imaging adoption [21], and treatment-failure tracking in antibiotic-first trials reveals imaging-derived predictors of subsequent complication [23,26].
Conclusions: Postoperative complication tracking is emerging as a diagnostic feedback mechanism, not merely a retrospective audit exercise, and closing the loop between pre-operative diagnosis and tracked outcomes should improve appendicitis diagnostic pathways going forward [20,24].
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