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Diagnostic imaging utilization in cases of acute appendicitis: multi-center experience
1Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
Journal of Korean Medical Science
|September 24, 2014
Summary
This study found that high computed tomography (CT) use in Seoul, Korea, is linked to a low negative appendectomy rate (NAR). Further increases in CT scans are unlikely to significantly reduce the NAR.
Area of Science:
- Radiology
- Surgical Outcomes
- Health Services Research
Background:
- The negative appendectomy rate (NAR) is a key indicator of appendectomy quality.
- Imaging plays a crucial role in diagnosing appendicitis and minimizing unnecessary surgeries.
Purpose of the Study:
- To assess imaging utilization and the negative appendectomy rate (NAR) in metropolitan Seoul, Korea.
- To investigate the association between initial imaging modality and NAR.
Main Methods:
- A cross-sectional study of 2321 patients (≥15 years) who underwent appendectomy in 2011.
- Analysis of imaging utilization (CT and ultrasonography) and NAR based on imaging strategy.
- Statistical analysis including adjusted odds ratios (AOR) and risk difference.
Main Results:
- Imaging utilization was 99.7%, with CT used initially in 93.1% and ultrasonography in 6.5%.
- The NAR was 3.3% for CT-only imaging versus 9% for ultrasonography-only.
- Using ultrasonography as the initial modality was associated with a higher NAR (AOR, 2.28).
Conclusions:
- Metropolitan Seoul demonstrates high CT utilization and a low NAR.
- While CT use is linked to lower NAR, current CT utilization levels may have reached a plateau for further significant NAR reduction.
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