Document Detail


Increased use of computed tomography does not harm patients with acute appendicitis.
MedLine Citation:
PMID:  16676857     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The increased use of computed tomography (CT) in patients with appendicitis may cause a delay in surgery and, therefore, higher perforation rates. We examined the use of CT, delay in time to surgery, and perforation rates in appendicitis patients operated on in two periods: Phase 1, 1996 through 1998 and Phase 2, 2001 through 2002. CT was performed in 18 per cent of the Phase 1 group compared with 62 per cent in the Phase 2 group. In the Phase 1 group, patients undergoing CT had a delay to surgery compared with those without CT (18.6 hours vs 7 hours; P < 0.0001). In the Phase 2 group, time to surgery was reduced (median time = 12 hours with CT vs 6 hours without CT; P < 0.001). CT was more accurate in the later group; there were less false-negative and equivocal studies. There was no difference in perforation rates between the Phase 1 and 2 groups. Over time, the increased use, efficiency, and accuracy of CT in patients with acute appendicitis were associated with reduced delays to surgery. The use of CT did not harm patients, but did not translate to better overall outcomes in this group of patients.
Authors:
Tehillah S Menes; Arthur H Aufses; Mary Rojas; Nina A Bickell
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American surgeon     Volume:  72     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-05-08     Completed Date:  2006-05-30     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  326-9     Citation Subset:  IM    
Affiliation:
Department of Surgery, Mount Sinai Medical School of Medicine, New York, New York 10029, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Appendectomy*
Appendicitis / radiography*,  surgery*
Child
Child, Preschool
Cohort Studies
Female
Humans
Male
Middle Aged
Outcome and Process Assessment (Health Care)
Retrospective Studies
Time Factors
Tomography, X-Ray Computed / trends*,  utilization*
Grant Support
ID/Acronym/Agency:
R01 B8509698//PHS HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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