Retrospective Cohort Study to Determine the Effect of Socioeconomic Status and Distance to Hospital on Negative Appendicectomy Rates in a Rural Setting.

Retrospective single rural hospital study, so findings may not apply to other hospitals and records may contain errors. It did not measure surgeon decision-making, prehospital clinical course, or treatment at peripheral hospitals and general practices. Socioeconomic status used 2016 postcode data, which may not describe patients' circumstances at the time of surgery. The study excluded patients who had interval appendicectomy, unrelated appendicectomy, lived outside the catchment, were prisoners, or were pregnant. The association with Indigenous background was incidental, the reason is unclear, and ethics limits prevented further exploration. Associations are not proof of cause; other factors may explain the findings.

The authors declared no conflicts of interest.

Do not read the null result for socioeconomic status and distance as proof that social disadvantage does not affect appendicitis care. The study only tested association with negative appendicectomy at one rural hospital, and it did not measure surgeon reasoning or prehospital care.