How long should people with appendicitis wait before going to theatre? 1822 people with presumed uncomplicated appendicitis admitted to hospital in Norway and Finland were randomised to have an appendicectomy either within 8 hours (which might mean operating overnight) or within 24 hours. There was no statistically significant difference in rates of perforation at appendicectomy between the two groups (8% and 9% respectively) or in outcomes at 30 days. The findings suggest that those with uncomplicated appendicitis—which in this study meant excluding people with a C reactive protein level of ≥100 mg/L, fever >38.5°C, signs of complicated appendicitis on imaging studies, or generalised peritonitis—can probably wait until morning.
Lancet doi:10.1016/S0140-6736(23)01311-9
JAMA goes into Private Eye mode this week with a research letter looking at financial conflicts of interests of doctors who comment as part of the National Coverage Determinations (NCD) process for medical devices—similar to …