Pre-hospital time and risk of perforation in patients with acute appendicitis in 112 countries (AlliGatOr): an international, prospective, observational cohort study.
BACKGROUND Acute appendicitis is the most common surgical emergency worldwide. Concern that delayed treatment might increase perforation can lead to unnecessary surgery and high rates of negative appendicectomy, where a normal, non-inflamed appendix is removed. However, whether perforation is related to pre-hospital ti...