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Published on: August 28, 2018
Routine versus selective computed tomography in non-traumatic acute abdominal pain: meta-analysis of randomised
Shahab Hajibandeh1,2, Mohamed Loutfi3, Shahin Hajibandeh4
1Department of General Surgery, Glan Clwyd Hospital, Rhyl, Denbighshire, UK. shahab_hajibandeh@yahoo.com.
Purpose:
To compare the routine vs. selective use of computed tomography (CT) in patients presenting with non-traumatic acute abdominal pain (AAP) to a surgical service.
Methods:
We conducted a systematic review of literature and meta-analysis of outcomes according to PRISMA statement standards to compare the routine vs. selective use of CT in adult patients presenting with non-traumatic AAP.
Results:
Analysis of 722 patients from 4 randomised controlled trials showed no difference between the routine CT and selective CT groups in terms of proportion of correct diagnoses (OR 1.36,95% CI 0.89, 2.07, P = 0.15), mortality (RD 0.03, 95% CI - 0.08, 0.02, P = 0.27] and length of hospital stay (LOS) [MD - 0.26, 95% CI - 2.07, 1.55, P = 0.78).
Conclusions:
The routine use of CT does not improve the proportion of correct diagnoses and mortality compared to selective use of CT in adult patients with non-traumatic AAP. The available evidence regarding the influence of routine CT on LOS may be subject to type 2 error. These findings, however, may not apply to the elderly patient with AAP and further studies are required.
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