Imaging May Reduce Negative Appendectomy Rate in Women
As computed tomography went up, negative appendectomies fell; link seen in young women
TUESDAY, Jan. 26 (HealthDay News) -- The use of preoperative computed tomography (CT) in women under the age of 46 years with suspected acute appendicitis was associated with a lower rate of negative appendectomy, according to research published in the February issue of Radiology.
Courtney A. Coursey, M.D., of the Duke University Medical Center in Durham, N.C., and colleagues analyzed data from 925 adults who underwent urgent appendectomy from 1998 to 2007.
The researchers found that the proportion of patients who underwent CT before the surgery increased from 18.5 percent in 1998 to 93.2 percent in 2007. Over this period, the negative appendectomy rate at the institution fell from 16.7 percent in 1998 to 8.7 percent in 2007. This decrease in the negative appendectomy rate was significant for females aged 45 years and younger; no significant association was seen in men or older women. The authors further note that false-positive and false-negative CT reports were more common for 7-mm than 5-mm section thickness.
"We believe that the risk of unnecessary surgery justifies the use of CT in patients in whom the clinical diagnosis of appendicitis is uncertain," Coursey and colleagues conclude, adding that the study, "along with the results of prior studies, supports the use of preoperative CT particularly in the evaluation of women of reproductive age suspected of having acute appendicitis. Furthermore, we believe the results of our study suggest that reconstruction section should be no more than 5 mm."
One author reported a financial relationship with GE Healthcare.