Bryan Dustin Pooler MD, Presenter: Nothing to Disclose

Joshua Suhonen, Abstract Co-Author: Nothing to Disclose

Edward Malnor Lawrence BS, Abstract Co-Author: Nothing to Disclose

Perry J. Pickhardt MD, Abstract Co-Author: Co-founder, VirtuoCTC, LLC Stockholder, Cellectar Biosciences, Inc

To evaluate temporal (hourly, daily, monthly, seasonal) variations in presentation for MDCT for the evaluation of suspected acute appendicitis in adults.

Over a ten year period, 2,844 consecutive adults (mean age 38.8 years) underwent MDCT for suspected appendicitis. 669 individuals (23.5%) ultimately proved to have appendicitis, which was perforated in 123 cases (18.4%). Temporal variation in presentation for MDCT according to the time of day, day of the week, month, and season was assessed, and positive versus negative cases and perforated versus non-perforated cases were compared.  

Significant hourly variation was present for total MDCT’s performed, with the peak hour from 1500-1600 (n=223) and the nadir from 0500-0600 (n=44) (p<0.001), but there was no significant hourly variation in positive rate. Significantly more MDCT’s were performed from 1600-midnight (n=1190) compared with 0800-1600 (n=993) and midnight-0800 (n=661) (p<0.001), and the positive rate was higher from midnight-0800 (30%) compared with 0800-1600 (20%) and 1600-midnight (23%) (p<0.001). Day of the week varied significantly for total MDCT’s performed (high of 458 on Friday, low of 267 on Saturday, p<0.001) and positive rate (low of 19% on Friday, high of 29% on Saturday, p=0.050), but not for perforation rate (high of 26% Friday, low of 12% Wednesday, p=0.109). Variation in MDCT usage by month (high of 265 MDCT’s in September, low of 204 MDCT’s in February, p=0.167) and season (high of 27% in fall, low of 23% in winter, p=0.059) was observed but was not statistically significant.

In this large cohort of adults undergoing MDCT for suspected appendicitis, a number of significant temporal variations in usage and outcome were observed.      

Temporal variations in presentation and outcome related to MDCT for acute appendicitis may have implications for clinical practice and staffing.

Pooler, B, Suhonen, J, Lawrence, E, Pickhardt, P, Temporal Variations in Presentation for MDCT for Suspected Acute Appendicitis in Adults.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14012043.html