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Appendicitis outcomes with increasing computed tomographic scanning.

Steven P Frei¹, William F Bond, Robert K Bazuro

¹Emergency Department, Lehigh Valley Hospital-Muhlenberg, Bethlehem, PA 18017, USA. steven.frei@lvh.com

The American Journal of Emergency Medicine

|December 18, 2007

Summary

This summary is machine-generated.

The widespread adoption of computed tomographic (CT) scanning for appendicitis led to fewer treatment delays and complications. However, the rate of negative appendectomies remained largely unchanged.

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Area of Science:

Medical Imaging
Surgical Outcomes
Emergency Medicine

Background:

Appendicitis diagnosis and management have evolved.
The integration of advanced imaging like computed tomographic (CT) scanning has impacted clinical practice.
Understanding the effect of CT scanning on appendicitis outcomes is crucial.

Purpose of the Study:

To evaluate the impact of increased computed tomographic (CT) scanning utilization on appendicitis outcomes.
To analyze trends in treatment delays, complications, negative appendectomies, and time to surgery.
To assess the relationship between CT scanning adoption and patient outcomes between 1998 and 2004.

Main Methods:

Retrospective chart review of appendectomy cases from 1998 to 2004.
Analysis of yearly data including CT scanning rates, treatment delays, complications, and negative appendectomies.
Definition of treatment delay as ED discharge on first visit or >20 hours from examination to surgery.

Main Results:

Computed tomographic (CT) scanning utilization increased significantly from 12.3% in 1998 to 84.4% in 2004.
Treatment delays decreased from 7.8% to 3.0%, and complications fell from 33.3% to 21.3% during the study period.
Negative appendectomy rates showed no significant change, while median time to surgery increased from 250 minutes to 370 minutes.

Conclusions:

Increased computed tomographic (CT) scanning correlated with significant reductions in appendicitis treatment delays and complications.
The rate of negative appendectomies did not substantially decrease with the rise of CT scanning.
Median surgical times increased, suggesting potential shifts in diagnostic and treatment pathways with enhanced imaging.