Evaluation of postoperative complication tracking as a Prognostic Tool in acute appendicitis

Liam Murphy; F. O'Brien; S. O'Brien

doi:10.5281/zenodo.22813493

Authors

Liam Murphy Division of General Surgery, Danube Institute of General Surgery Author https://orcid.org/8582-1958-6936-038X
F. O'Brien Department of General Surgery, Brahmaputra Academy of General Surgery Author https://orcid.org/3116-5503-1878-5676
S. O'Brien Department of Clinical General Surgery, Don Center for Surgical Research Author https://orcid.org/0316-2058-0599-3967

DOI:

https://doi.org/10.5281/zenodo.22813493

Keywords:

appendicitis, postoperative complications, Clavien-Dindo classification, prognosis, surgical outcomes

Abstract

Graphical abstract

Background: Whether structured complication tracking with the Clavien-Dindo classification carries independent prognostic value in acute appendicitis, beyond serving as a retrospective audit tool, has not been directly examined.

Objective: To evaluate whether tracked Clavien-Dindo grade predicts length of stay, 30-day readmission and reoperation after appendectomy, and how it compares with preoperative diagnostic risk scores.

Methods: In a retrospective cohort of consecutive adults undergoing appendectomy for suspected acute appendicitis, postoperative complications were graded by blinded reviewers using the Clavien-Dindo classification and, for a subset, the comprehensive complication index.

Results: Complication grade rose progressively with length of stay and readmission risk, with the strongest inflection from grade II to grade III. Preoperative diagnostic scores correlated only weakly with subsequent grade, while operative severity and delay among complicated cases were more informative.

Conclusions: Structured Clavien-Dindo tracking is a useful prognostic tool in acute appendicitis, with value concentrated at the major-morbidity threshold, and it answers a distinct clinical question from preoperative diagnostic scoring.

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