Textbook Outcomes in Urgent Appendectomy

Classical assessments, focused solely on mortality and morbidity, are increasingly considered insufficient. A more comprehensive approach, using composite measures, offers a more accurate evaluation, providing a multidimensional view and patient-centred healthcare appraisal. The textbook outcome (TO) is the most used objective composite measure to compare surgical quality across centres

From diagnostic of Acute Appendicitus to Surgical Treatment should be less than 24h

Optimal hospital stay should be less than 5 days

Intraoperative bleeding, perforation of the appendix, iatrogenic injury to other structures

Less than 72h of antibiotic treatment

Charlson Comorbidity Index

ASA Scoring System

AAST classification AAST I: Acutely inflamed appendix, intact. AAST II:Gangrenous appendix, intact AAST III:Above, with evidence of local contamination AAST IV:Above, with abscess or phlegmon in region of appendix AAST V:Above, with addition of generalized purulent contamination away from appendix

WSES Classification:

Grade- 0 (normal looking) Grade-1 (inflamed) Grade- 2A and 2B (necrosis) Grade- 3A - 3B - 3C (perforated - inflammatory tumor) Grade- 4 (perforate - diffuse peritonitis)

Clavien Dindo and CCI (https://www.cci-calculator.com/)

Grade I: Any deviation from the normal postoperative course without the need for pharmacological treatment or surgical, endoscopic, and radiological interventions.

Grade II:Requiring pharmacological treatment with drugs other than such allowed for Grade I Grade III:Requiring surgical, endoscopic or radiological intervention. Grade IV:Life-threatening complication (including CNS complications)* requiring IC/ICU-management with single or multiorgan disfunction.

Grade V: Death of a patient

Percentage of readmission