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Children's Acute Surgical Abdomen Programme: understanding processes of care in children undergoing emergency surgery for suspected appendicitis

Appendicitis is one of the most common reasons children need emergency surgery. This study looked at how well NHS hospitals follow best practice standards for children having surgery to remove the appendix, and whether this affects their recovery.

Using data from 2,799 children in 80 hospitals between 2019 and 2022, the study examined the type of care children received, where it was provided, and patient factors such as age and other health conditions.

The research found important variation in care across hospitals:
 

• Only 43% of children had recommended scans before surgery to confirm the diagnosis.

• Around 71% received multimodal pain relief (using more than one type of pain treatment, which is considered best practice).

• About 73% had their operation within 24 hours of arriving at hospital, as guidelines recommend.

Children treated in specialist children’s hospitals were generally younger, had more complex health conditions, and were more likely to have complicated appendicitis. These hospitals were more likely to use scans before surgery, but less likely to operate within 24 hours.

Interestingly, children who went on to have complications after surgery often received care that met higher standards, suggesting that their poorer outcomes were more related to their underlying health or condition rather than the quality of care provided.

Lead Investigator

Ramani Moonesinghe