Sean Chang, Presenter: Nothing to Disclose

Steven Satish Raman MD, Abstract Co-Author: Nothing to Disclose

Tyler Lee Crawford MD, Abstract Co-Author: Nothing to Disclose

Seth Cardall, Abstract Co-Author: Nothing to Disclose

Barbara M. Kadell MD, Abstract Co-Author: Nothing to Disclose

James Sayre PhD, Abstract Co-Author: Nothing to Disclose

David Shin-Kuo Lu MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

In routine clinical practice, to determine the impact of increased utilization rate of preoperative helical CT for suspected acute appendicitis on the appendiceal perforation rate and negative appendectomy rate in adults.

With IRB approval, the medical records of 867 consecutive patients (men: 494, women: 373) aged 16 – 90 who underwent appendectomy for suspected acute appendicitis between 1996 and 2004 were reviewed. The annual percentage of patients who underwent preoperative CT, and/or sonography (ultrasound) was derived along with annual rates of negative appendectomy and perforated appendicitis (surgical and pathological). Using linear regression analysis, the trend in annual CT utilization rate was correlated with the negative appendectomy and perforation rates.

From 1996 to 2004, the CT utilization rate increased from 19.7% in to 87.4% (p=0.001) and the ultrasound utilization rate decreased from 23.7% to 3.2%. The negative appendectomy rate decreased from 23.7 to 1.5% (p=0.001) (men: 25.6 % to 1.5 % and women 21.6% to 0.0%) while the surgical and pathological appendiceal perforation rates decreased from 22.4% and 18.4% to 7.4% and 9.5% respectively. Using linear regression, there was a significant (p<0.001) inverse relationship between the increased CT utilization rate and both negative appendectomy rate and appendiceal perforation rates. These trends were similar across age groups in the male and female cohort.

Between 1996 and 2004, increased preoperative CT utilization has correlated with a significant, clinically relevant decrease negative appendectomy and appendiceal perforation rates among adult men and women.

Chang, S, Raman, S, Crawford, T, Cardall, S, Kadell, B, Sayre, J, Lu, D, et al, , Impact of Increased Preoperative Helical CT Utilization on Negative Appendectomy and Appendiceal Perforation Rates in 867 Patients with Suspected Acute Appendicitis.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4415911.html