Background:

Acute appendicitis stands out as a frequently encountered surgical emergency. Despite decades of experience and research, the diagnosis remains a formidable challenge, particularly in young females experiencing acute abdominal pain, where the assessment requires consideration of a broader spectrum of potential causes. An overarching concern lies in the risk of over-treatment, leading to an escalation in unnecessary surgeries, known as the negative appendectomy rate (NAR). This elevated NAR is associated with postoperative complications, prolonged hospital stays, and avoidable healthcare expenditures. Despite international guidelines recommending the routine use of risk prediction models for patients with acute abdominal pain, reported NAR values have reached as high as 28.2% in females and 12.1% in males.

Aim:

The primary study aim is to identify optimal risk prediction models for acute RIF pain in Turkey.

The secondary aims are to audit the normal appendicectomy rate, assess whether these scores have similar efficacy in immigrants, and demonstrate nationwide clinical trends to discuss possible improvements.

Inclusion Criteria:

• All consecutive patients referred to general surgeons with right iliac fossa pain or suspected appendicitis.
• All patients who undergo an appendicectomy during the study period.

Exclusion Criteria:

• Previous appendicectomy, right hemicolectomy, or total colectomy.
• Previous abdominal surgery in the last 90 days.
• Pregnancy.
• Patients confirmed with COVID-19.

Patients referred to general surgeons with right iliac fossa pain or suspected appendicitis.