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- M Petrosyan, J Estrada, S Chan, S Somers, W N Yacoub, R L Kelso, and R J Mason.
- Division of Emergency Surgery, Department of Surgery, Keck School of Medicine of University of Southern California and Los Angeles County + USC Medical Center, Los Angeles, Calif., USA.
- Eur Surg Res. 2008 Jan 1;40(2):211-9.
ObjectiveTo determine the influence of computed tomography (CT) scans on diagnosis and management of patients with suspected appendicitis.MethodsRetrospective 2-year review of 1,630 patients with suspected appendicitis, categorized into three groups based on the likelihood (Alvarado scores) of having appendicitis. Group 1: low likelihood (Alvarado score < or =4); group 2: intermediate likelihood (Alvarado scores 5-7), and group 3: high likelihood (Alvarado score > or = 8). CT scan utilization, hospital course, and final pathology were retrospectively reviewed.ResultsMore patients received a CT scan in 2006 as compared with 2005 (60 vs. 52%; p = 0.001). The overall appendectomy rate was similar between the 2 years (57% in 2005 vs. 57% in 2006; p = 0.995). The overall appendectomy rate in patients with a CT was significantly higher as compared with those without (60 vs. 53%; p = 0.002). The appendectomy rate in patients with Alvarado scores < or =4 and no CT scan was significantly lower than in those with a CT scan (12 vs. 48%; p < 0.0001). The overall negative appendectomy rate in patients with a CT scan was similar to that in those without: 31/546 (6%) vs. 23/383 (6%).ConclusionsCT scan utilization increased the appendectomy rate only in patients with a low clinical suspicion for appendicitis. Preoperative CT scans did not decrease the negative appendectomy rate.Copyright 2008 S. Karger AG, Basel.
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