Imaging utilization affects negative appendectomy rates in appendicitis: An ACS-NSQIP study - 24/05/19
Abstract |
Background |
Negative appendectomy rates (NAR) historically ranged from 15 to 25%, but have decreased recently.
Methods |
Using the 2016 ACS-NSQIP database, we identified patients who underwent appendectomies for appendicitis. Patients with and without appendicitis on pathology were compared. Multivariate analysis was used to identify predictors of negative appendectomies.
Results |
11,841 patients underwent appendectomies, with a NAR of 4.5%. Utilization rates of US, CT and MRI were 14.9%, 86.1%, and 1.1%. NAR's of US, CT, and MRI were 9.7%, 2.5%, and 7.1%, and 19.2% for patients without imaging. An ultrasound consistent with appendicitis has a NAR of 4.8%; adding a CT decreases it to 0.6%. Predictors of NA include females, smoking, no imaging, and ultrasounds. Factors with lower odds of NA include leukocytosis, sepsis, and CTs.
Conclusions |
The NAR in the 2016 ACS-NSQIP population is 4.5%. CTs are the most frequently used imaging modality and have the lowest NAR. Obtaining a CT in addition to an ultrasound is associated with lower NAR. This should be further explored with a cost-benefit analysis between multiple imaging studies versus negative appendectomies.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | The negative appendectomy rate is 4.5% in the 2016 ACS-NSQIP population. |
• | CTs have the lowest negative appendectomy rates of all imaging modalities. |
• | Patients with ultrasounds and CTs have lower negative appendectomy rates than ultrasound alone. |
Keywords : Negative appendectomy, Appendicitis, Imaging utilization, NSQIP
Mappa
Vol 217 - N° 6
P. 1094-1098 - giugno 2019 Ritorno al numero
Articolo precedente
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