{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:50:11Z","timestamp":1780638611608,"version":"3.54.1"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Surgeons are sometimes reluctant to manage uncomplicated appendicitis non\u2010operatively. Reasons cited include the risk of recurrent appendicitis and the risk of missed appendiceal malignancy. The aim of this study was to address these uncertainties and determine the long\u2010term efficacy of antibiotic versus operative management of appendicitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>One\u2010year follow\u2010up of patients enrolled in the multicentre, COVID:HAREM cohort study during March\u2010June 2020 was performed. Initial operative or non\u2010operative management was determined on a case\u2010by\u2010case basis by the responsible surgeon. Outcomes were appendicectomy rate at 1\u2010year, histology of removed appendix and predictors of unsuccessful antibiotic treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 625 patients who had non\u2010operative management were included. Emergency appendicectomy had been performed by 1\u2010year in 24% (149\/625), with a median time to appendicectomy of 12\u00a0days [IQR 1\u201377] from presentation. Thirty\u2010one patients had elective appendicectomy. Normal histology was reported in 6% of emergency procedures and 58% of elective ones. There were 7 malignancies and 3 neuroendocrine tumors identified at histology. All patients with malignant histology had \u22651 risk factors for malignancy at initial presentation. Faecolithiasis (hazard ratios (HR) 2.3, 95% confidence intervals (CI) 1.51\u20133.49) and a high Adult Appendicitis Score (AAS &gt;16; HR 2.44, 95% CI 1.52\u20133.92) were independent risk factors for unsuccessful non\u2010operative management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>At 1\u00a0year, 71% of patients managed non\u2010operatively did not undergo an appendicectomy. Recurrence of appendicitis was associated with faecolithiasis and a high AAS. Patients at higher risk for appendiceal malignancy should have targeted follow\u2010up. These factors should be considered when counseling patients on non\u2010operative management.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12337","type":"journal-article","created":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T02:29:53Z","timestamp":1727404193000},"page":"2658-2668","source":"Crossref","is-referenced-by-count":3,"title":["Predictors of appendicectomy one year after antibiotic treatment for acute appendicitis: Insights from a prospective, multicentre, observational study"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4270-5020","authenticated-orcid":false,"given":"Hannah","family":"Javanmard\u2010Emamghissi","sequence":"first","affiliation":[{"name":"Division of Medicine and Health Science University of Nottingham at Derby Royal Derby Hospital  Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Doleman","sequence":"additional","affiliation":[{"name":"Division of Medicine and Health Science University of Nottingham at Derby Royal Derby Hospital  Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan N.","family":"Lund","sequence":"additional","affiliation":[{"name":"Division of Medicine and Health Science University of Nottingham at Derby Royal Derby Hospital  Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Hollyman","sequence":"additional","affiliation":[{"name":"Exeter NIHR Biomedical Research Centre Royal Devon and Exeter Hospital  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan J.","family":"Moug","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal Alexandra Hospital  Paisley UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian M.","family":"Tierney","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal Derby Hospital  Derby 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