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[Impact of imaging tests on the negative appendectomy rate]
E Rodríguez Cuellar1, M Gutiérrez Andreu, P Gómez Rodríguez
1Servicio de Cirugía General A, Hospital Universitario 12 de Octubre, Madrid, España. elias.rodriguez@gmail.com
Summary
This study analyzed emergency appendectomies, finding a 9.6% negative appendectomy rate. While imaging use was lower than in the USA, CT-scan showed high diagnostic accuracy for acute appendicitis.
Area of Science:
- Surgical Quality Improvement
- Diagnostic Imaging in Surgery
Background:
- Negative appendectomy and perforated appendectomy rates are traditional surgical quality indicators.
- Acute appendicitis diagnosis relies on timely and accurate assessment.
Purpose of the Study:
- To analyze emergency appendectomies, focusing on imaging test utilization.
- To review literature and assess diagnostic quality for acute appendicitis.
Main Methods:
- Retrospective study of 394 patients operated for suspected acute appendicitis in 2007.
- Data collected from histology and imaging reports.
- Analysis of diagnostic accuracy of imaging tests and comparison with international literature.
Main Results:
- Overall negative appendectomy rate was 9.6%.
- Abdominal ultrasound (AU) used in 54.6%, CT-scan in 10.2%.
- CT-scan demonstrated a higher positive predictive value (97%) compared to AU (82%).
Conclusions:
- The center's negative appendectomy rate is lower than historical data but higher than recent US rates.
- Imaging test utilization is lower than in the USA but comparable to European countries.
- CT-scan offers superior diagnostic accuracy for acute appendicitis.
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