CompletedNot Applicable

RICA (ERAS) Pathway Adherence and Early Discharge Feasibility After Urgent Uncomplicated Appendectomy (APENERAS)

Spain193 participantsStarted 2022-12-07

Plain-language summary

This multicenter, prospective observational study (APENERAS) evaluates adherence to the RICA (ERAS Zaragoza 2022) perioperative care pathway in adults undergoing urgent laparoscopic appendectomy for uncomplicated acute appendicitis. The study aims to describe real-world adherence to the pathway across participating hospitals and to explore its association with patient safety and recovery outcomes. Key outcomes include postoperative complications (including severity), length of hospital stay, and readmissions within 30 days. Patient-reported satisfaction is also assessed using a structured survey. In addition, the study evaluates the feasibility of early discharge/ambulatory management by intention-to-treat, using a standardized checklist of clinical, functional, and social discharge criteria assessed during the first 24 hours after surgery. No changes to usual clinical care are introduced. Data are collected from routine perioperative management and follow-up.

Who can participate

Age range18 Years – 75 Years

SexALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria: * Age ≥ 18 and ≤ 75 years. * Immunocompetent patients. * ASA physical status I-III. * Preoperative diagnosis of uncomplicated acute appendicitis (based on clinical assessment, laboratory tests, and imaging such as ultrasound and/or CT according to availability). * Indication for urgent appendectomy for uncomplicated appendicitis. * Laparoscopic approach. * Expected operative time \< 90 minutes. * Cooperative patient able to understand and follow instructions. * Voluntary participation and written informed consent. * Adequate social/family support (availability of a responsible adult for transport home and support during the first postoperative days). * Travel time from home to hospital \< 1 hour and access to transportation. * Acceptable home environment for recovery (telephone access and basic habitability/hygiene). Exclusion Criteria: * ASA physical status IV. * Age \< 18 years or \> 75 years. * BMI \> 35 kg/m² with significant respiratory or cardiovascular complications. * Ischemic heart disease class IV or acute myocardial infarction within the last 6 months. * Congestive heart failure NYHA class III-IV. * Sleep apnea or severe COPD, or need for home oxygen therapy. * Poorly controlled diabetes mellitus. * Severe psychiatric disorders, drug addiction, or severe alcoholism. * History of major anesthesia-related complications or malignant hyperthermia. * Epilepsy. * Pregnancy. * Use of anticoagulants, MAO inhibitors, systemic corticosteroids, or immun…

What they're measuring

Overall adherence to the RICA (ERAS Zaragoza 2022) pathway

Timeframe: From day of surgery through postoperative day 2 or hospital discharge (whichever occurs first).

Trial details

NCT IDNCT07401407

SponsorHospital Galdakao-Usansolo

Sponsor typeOTHER_GOV

Study typeOBSERVATIONAL

Primary completion2025-01-27