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Increased use of computed tomography does not harm patients with acute appendicitis
Tehillah S Menes1, Arthur H Aufses, Mary Rojas
1Department of Surgery, Mount Sinai Medical School of Medicine, New York, New York 10029, USA.
The American Surgeon
|May 9, 2006
Summary
Computed tomography (CT) use for appendicitis increased, improving efficiency and accuracy over time. While CT reduced surgical delays, it did not significantly alter perforation rates or overall patient outcomes.
Area of Science:
- Medical Imaging
- Surgical Outcomes
- Emergency Medicine
Background:
- Computed tomography (CT) utilization in appendicitis diagnosis has risen.
- Concerns exist regarding potential delays in surgical intervention and increased perforation rates due to CT use.
Purpose of the Study:
- To evaluate the impact of increased computed tomography (CT) use on surgical delays and perforation rates in appendicitis patients.
- To compare outcomes between two distinct time periods with varying CT utilization.
Main Methods:
- Retrospective analysis of appendicitis patients operated on during two phases: 1996-1998 (Phase 1) and 2001-2002 (Phase 2).
- Comparison of CT utilization rates, time to surgery, and perforation rates between the two phases.
- Assessment of CT accuracy in diagnosing appendicitis.
Main Results:
- CT use increased from 18% in Phase 1 to 62% in Phase 2.
- In Phase 1, CT was associated with a significant delay in surgery (18.6 vs 7 hours).
- In Phase 2, time to surgery was reduced with CT use (12 vs 6 hours), and CT accuracy improved with fewer false-negative and equivocal studies.
- No significant difference in perforation rates was observed between the two phases.
Conclusions:
- Increased use, efficiency, and accuracy of CT for appendicitis are associated with reduced surgical delays.
- CT use in appendicitis management did not lead to higher perforation rates or improved overall outcomes in this study.
- Further research may be needed to optimize CT protocols for better patient outcomes in appendicitis.
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