Are negative appendectomies still acceptable?
BACKGROUND
The goal was to ascertain if there was a significant change in the negative appendectomy (NA) rate in our community hospital with the increased use of computed tomography (CT).


METHODS
This was a retrospective chart review of all appendectomies for acute disease performed at our institution from January 2000 to December 2002. There is no established protocol; therefore, CT scans were performed at the discretion of the involved physicians. The results of the physical exams, CT scans and pathology were recorded.


RESULTS
Three hundred eighty-nine appendectomies were performed for appendicitis. There was a progressive increase in the use of CT: 52% in 2000, 74% in 2001, and 86% in 2002. There was also a decrease in the NA rate over the 3 years: 17% in 2000, 9% in 2001 and 2% in 2002. The perforated appendicitis rate decreased from 25% in 2000 to 9% in 2002.


CONCLUSIONS
The appropriate utilization of CT scan as an aid in the diagnosis of acute appendicitis should decrease the NA rate to 2%.
Jones
Kory
K
Department of Surgery, Methodist Hospitals of Dallas, PO Box 655999, 1441 North Beckley Avenue, Dallas, TX 75265-5999, USA.
Peña
Alberto A
AA
Dunn
Ernest L
EL
Nadalo
Lennard
L
Mangram
Alicia J
AJ
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000379:methods / Q000706:statistics & numerical data*; D001064:Appendicitis / Q000000981:diagnostic imaging* / Q000601:surgery*; D016009:Chi-Square Distribution; D005069:Evaluation Studies as Topic; D005188:False Negative Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*