Investigator(s)
| Submitter |
Tandi Wangdi Trashigang Cluster Hospital National Medical service Trashigang, Bhutan Tandi Wangdi 
|
| Principal Investigator |
Tandi Wangdi Trashigang Cluster Hospital National Medical service Trashigang, Bhutan Tandi Wangdi
|
| Co-Investigator(s) |
Karma Yeshi General Duty Medical Officer, Trashigang General Hospital National Medical Service Trashigang, Bhutan Karma Yeshi
|
| Co-Investigator(s) |
Norbu Tshomo General Duty Medical Officer, Trashigang General Hospital National Medical Service Trashigang, Bhutan Norbu Tshomo
|
| Co-Investigator(s) |
Loday Zangmo General Duty Medical Officer, Trashigang General Hospital National Medical Service Trashigang, Bhutan Loday Zangmo
|
| Co-Investigator(s) |
Sangay Wangmo General Surgeon Central Regional Referral Hospital Gelephu, Bhutan Sangay Wangmo
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| Co-Investigator(s) |
Jigme Sherub General Surgeon Tsirang General Hospital National Medical Service Tsirang, Bhutan Jigme Sherub
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| Co-Investigator(s) |
Tsheten Wangchuk General Surgeon Eastern regional Referral Hospital National Medical Service Mongar, Bhutan Tsheten Wangchuk
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| Co-Investigator(s) |
Thinley Phuntsho General Surgeon JDW National Referral Hospital National Medical Service Thimphu, Bhutan Thinley Phuntsho
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| Co-Investigator(s) |
Tshering Pelzom General Surgery Resident Y3 KGUMSB Thimphu, Bhutan JDW National Referral Hospital Tshering Pelzom
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| Co-Investigator(s) |
Khandu Wangchuk General Surgery Resident Y3 KGUMSB Thimphu, Bhutan JDW National Referral Hospital Khandu Wangchuk
|
Title(s) and abstract
| Scientific title | A global prospective cohort study on outcomes of appendicectomy for appendicitis |
| Public title | AlliGatOr |
| Background | Acute appendicitis is one of the most common surgical emergencies worldwide. Presentation of appendicitis and its management can serve as a benchmark to evaluate the efficiency and effectiveness of emergency health systems. The aim of this prospective cohort study is to identify areas for whole systems strengthening in emergency care using pre-defined key performance measures. |
| Objectives | This study will generate granular data on the global variability in appendicectomy management and outcomes, offering insights into access to emergency care, imaging, and minimally invasive surgery. The findings will guide recommendations for both high-income and low- and middle-income countries, informing government policy and improving patient outcomes. |
| Study Methods | This international prospective, multicentre, cohort study will include consecutive patients undergoing appendicectomy for suspected appendicitis. A measurement set comprising key outcome measures has been pre-defined to comprehensively evaluate emergency system performance across the world. Hospital teams of up to 3 collaborators will collect data on consecutive patients of any age undergoing appendicectomy in pre-defined 14-day blocks. Patients will be followed up at 30-days to collect outcome data. Multiple teams may participate in data collection in the same hospital but in different 14-day blocks. There will be no changes made to routine patient care pathways/management or follow-up in this observational study. Two hospital level surveys will be included in the study. One is a mandatory site survey for all hospitals participating and the second will be an optional World Health Organisation hospital emergency assessment tool survey. There will be two nested sub-studies on sustainability and waste management, and financing. Consultant Leads in each participating hospital must ensure appropriate study registration approval as per local regulations and this is mandatory for participation. |
| Expected outcomes and use of results | The primary aim is to identify areas for system strengthening in emergency surgery using appendicitis as a tracer condition with a pre-defined key performance measurement set. The secondary aims of this study are to evaluate variations in the presentation, diagnosis, management, access to minimally invasive surgery, and outcomes of patients that have surgery for suspected acute appendicitis. Variation could be assessed across groups stratified by human development index, hospital funding, urban/rural, and facility level. |
| Keywords | Emergency surgery, appendisitis, minimal invasive surgery, Global Surgery |
Research Details
| Student research | No |
| Start Date | 01-Feb-2025 |
| End Date | 01-Jul-2025 |
| Key Implementing Institution | NIHR, Global Health Research Unit on Global Surgery |
| Multi-country research | Yes |
| India, Bhutan, Bangladesh, Nepal | |
| Nationwide research | Yes, with randomly selected geographical areas |
| Bhutan, Bhutan, Bhutan, Bhutan | |
| Research Domain(s) | Non-communicable diseases & Healthy Lifestyles |
| Research field(s) | Infectious Disease |
| Involves human subjects | Yes |
| Qualitative Study | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | Approved |