Negative appendectomy rate: influence of CT scans.
Negative appendectomy rate varies significantly depending on patient age and sex. However, the impact of computed tomography (CT) scans on the diagnosis of appendicitis is unknown. The goal of this study was to examine the negative appendectomy rate using a statewide database and analyze the association of receipt of CT scan. Using the California Inpatient File, all patients undergoing appendectomy in 1999-2000 were identified (n = 75,452). Demographic and clinical data were analyzed, including procedure approach (open vs laparoscopic) and appendicitis type (negative, simple, abscess, peritonitis). Patients with CT scans performed were identified to compare the negative appendectomy rate. For the entire cohort, appendicitis type was 59 per cent simple, 10 per cent with abscess, 18.7 per cent with peritonitis, and 9.3 per cent negative. Males had a lower rate of negative appendicitis than females (6.0% vs 13.4%, P < 0.0001). The use of CT scans was associated with an overall lower negative appendectomy rate for females, especially in the < 5 years and > 45 years age categories. Use of CT scans in males does not appear to be efficacious, as the negative appendectomy rates were similar across all age categories. In conclusion, use of CT was associated with lower rate of negative appendectomy, depending on patient age and sex.
David Geffen School of Medicine, University of California, Los Angeles, Department of Surgery, 10833 Le Conte Avenue, 72-215 Center for Health Sciences, Box 956904, Los Angeles, CA 90095-6904, USA.
Marcia L
ML
McGory
David S
DS
Zingmond
Darshani
D
Nanayakkara
Melinda A
MA
Maggard
Clifford Y
CY
Ko
D000293:Adolescent; D000328:Adult; D001062:Appendectomy / Q000706:statistics & numerical data*; D001064:Appendicitis / Q000000981:diagnostic imaging* / Q000601:surgery*; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed