Appendicectomy: Evaluation of medical file management in a series of 200 cases.

To improve the management of appendicular syndromes, two hundred files of p atients undergoing appendectomy in an emergency surgery department between January 1993 and August 1994 were submitted to a retrospective and descript ive study with evaluation of the medical file content. To evaluate clinical and investigations data collecting, a histopathological review protocol wa s elaborated to obtain an objective and reliable criterion of the degree of inflammation of the appendix. This review was possible only for 197 files that were included. Data collecting rates are inferior than expected rates, particularly for the association of temperature, abdominal defence and whi te blood cells count that was found in only 159 Files (80.7 %). Data were l ess collected for women, patients operated by coelioscopy and when histopat hologic review concluded to absence of acute inflammation. Rate of acute ap pendicitis was 73.6%(145/197). Appendectomies without acute inflammation we re higher for women (34.6% = 37/107) than for men (16.7% = 15/90) and for p atients who underwent coelioscopic appendectomy (42.9% = 33/77) than for pa tients who underwent Mac Burney appendectomy (16% = 19/119). These results highlight the need to improve competition of medical files with better coll ection of clinical data, which could lead to improve care quality and manag ement of operated appendicular syndromes, first step to a reduction of the number of appendectomies. A global assessment of file completion could be p roposed on the basis of clinical audit.