Pre-Operative Imaging can Reduce Negative Appendectomy Rate in Acute Appendicitis

Area of Science:

• Surgical Emergency Management
• Diagnostic Imaging in Medicine
• Healthcare Economics

Background:

• Acute appendicitis is a frequent surgical emergency with a substantial negative appendicectomy rate (NAR) of 15-25%.
• Negative appendicectomy occurs when a patient suspected of appendicitis has a normal appendix removed.

Purpose of the Study:

• To assess the negative appendicectomy rate within a specific hospital unit.
• To evaluate the impact of pre-operative imaging, specifically CT scans, on the NAR.
• To analyze the cost-effectiveness of implementing pre-operative imaging for suspected appendicitis.

Main Methods:

• A retrospective analysis of emergency appendicectomies (open and laparoscopic) performed between 2017-2018.
• Exclusion of patients under 18 years old.
• Calculation of costs based on the 2017/18 national tariff payment system.

Main Results:

• Pre-operative CT scans were utilized in 29.74% of the 232 included patients.
• The negative appendicectomy rate was significantly lower with pre-operative CT (7.25%) compared to without (22.09%).
• Implementing pre-operative CT could lead to substantial cost savings, estimated at £36,212, by reducing unnecessary surgeries.

Conclusions:

• Pre-operative imaging is effective in improving the accuracy of appendicitis diagnosis and reducing the negative appendicectomy rate.
• The adoption of pre-operative imaging for suspected appendicitis cases offers significant cost benefits and optimizes resource allocation in healthcare.