Diagnostic Algorithm for Appendizitis (DIALAPP)
Diagnostic Algorithm for Appendizitis (DIALAPP)
The diagnosis of acute appendicitis remains a challenge in daily clinical practice. The high
 incidence of appendicitis drives the need to reduce morbidity and unnecessary costs due to
 negative appendectomies. The aim of the present observation study is to evaluate a diagnostic
 and therapeutic algorithm for suspected acute appendicitis.

 The investigators believe that this diagnostic algorithm helps to simultaneously avoid
 unnecessary operations, costs and radiation exposure.
This prospective observation study will be performed in the university hospital Frankfurt
 with a 24-h emergency service, with surgery and radiology readily available. The data will be
 compiled on patients older than 18 years who will be admitted to the emergency unit with
 suspected appendicitis.

 During the study period, the clinical workflow is standardized. In all cases a resident of
 surgery and/or consultant surgeon clinically evaluate and perform an ultrasound scan on all
 patients with suspected appendicitis. With the use of clinical and laboratory results the
 physician (surgeon) will calculate the Alvarado Score and depending on the result the next
 diagnostic steps or the treatment will be chosen. Additionally, the department of gynecology
 of the university hospital routinely evaluate all women of childbearing age. Upon other terms
 following variables will be collected: age, gender, white blood cells (WBC), C-reactive
 protein (CRP), Alvarado Score, visuell pain scale, CT scan results, pathologic findings, time
 between admission and operation, operation procedure, treatment and diagnosis of patients
 without operation, length of hospital stay, and 30-day complication rate. Furthermore, there
 will be a follow-up of all patients (with and without operation) after 30 days and 6 months.

 The investigators assume that the use of a diagnostic and therapeutic algorithm reduces
 unnecessary negative appendectomies and optimizes the duration of the hospital stay and the
 costs.
Inclusion Criteria:

 -  complete evaluation, examination and diagnostic pathways of the patients with
 suspected appendicitis in our University Hospital

 Exclusion Criteria:

 -  appendectomy during other operations