TITLE

Influence of Preoperative Computed Tomography on Patients Undergoing Appendectomy

AUTHOR(S)
McDonald, Gregory P.; Pendarvis, Derek P.; Daley, Brian J.; Wilmoth, Rob
PUB. DATE
November 2001
SOURCE
American Surgeon;Nov2001, Vol. 67 Issue 11, p1017
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The frequency of computed tomography (CT) ordered by emergency department physicians at our facility was noted to sharply increase in early 1998 after a New England Journal of Medicine (NEJM) article recommending routine CT in patients with suspected appendicitis. Numerous studies have proven the accuracy of CT for detecting acute appendicitis; however, the most appropriate use of CT continues to evolve. We sought to evaluate the effect of increased CT use on negative appendectomy rate and perforation rate at our institution and to better delineate in whom CT is most beneficial. CT use was retrospectively evaluated and found to sharply increase in April 1998. The authors then reviewed the medical records of 291 consecutive patients undergoing appendectomy 18 months before and after the NEJM article. Patients with interval appendectomies and those 12 years of age or younger were excluded. The remaining 226 patients constitute the study cohort. The study cohort was then divided into the two groups. The "Discriminate Group" consists of patients from the 18 months before the NEJM article impact and a period of selective CT use. The "Indiscriminate Group" comprises patients from the subsequent 18 months in which CT use was substantially higher and routinely obtained before surgical evaluation. After chart review an objective clinical score (Alvarado score) was assigned to each patient. Comparison was then made between the two groups on perforation rate, negative appendectomy rate, time delay to operating room, and Alvarado score. Additionally patients undergoing preoperative CT were compared with those without CT. These groups were also evaluated on the basis of negative appendectomy rate, perforation rate, and delay to the operating room. CT in patients with abdominal symptoms associated with appendicitis increased from 188 in the Discriminate Group to 1035 in the Indiscriminate Group. In the Discriminate Group the negative appendectomy rate was 15.1 per cent...
ACCESSION #
5562950

 

Related Articles

  • Univ. of Tenn. Med. Ctr.: Retail Units Rev-Up Sales, Customer-Counts. Bond, Marian // FoodService Director;05/15/99, Vol. 12 Issue 5, p68 

    Reports on the opening of a Taco Bell Express and a Pizza Hut unit in the foodcourt of The University of Tennessee Medical Center. Features of the foodcourt; Sales of the two branded stores; Effects of the stores' opening in the total sales of the foodcourt.

  • Agreements/contracts.  // Medical Device Daily;7/21/2010, Vol. 14 Issue 140, p4 

    The article reports that the University of Tennessee Medical Center has chosen the SafetyConnect patient safety program of Premier.

  • Does Alcohol Intoxication Alter the Assessment and Outcome of 'Observation-Status' Trauma Patients? McCadams, Joseph S.; Daley, Brian J.; Enderson, Blaine L. // American Surgeon;Nov2001, Vol. 67 Issue 11, p1110 

    We assessed the effect of blood alcohol concentration (BAC) on the evaluation, outcome, and hospital charges of our observation-status trauma patient population. We conducted a retrospective study over 18 months; any patient initially admitted with <24-hour observation status, Glasgow Coma Score...

  • Food City cooks up wellness in the Healthy Living Kitchen.  // Drug Store News;3/14/2011, Vol. 33 Issue 4, p30 

    The article reports on the partnership of supermarket and pharmacy operator Food City and the University of Tennessee Medical Center in Knoxville designed to expand and offer the latter's Healthy Living Kitchen nutrition education program to community events, schools and local stores in the U.S.

  • The University of Tennessee Medical Center at Knoxville. Goldman, Mitchell H. // American Surgeon;Sep2012, Vol. 78 Issue 9, p909 

    The article provides information on the University of Tennessee Medical Center at Knoxville, Tennessee (UTMCK). UTMCK was founded as The University Memorial Hospital and Research Center in August 1956. Residencies, administrators and resident physicians who served at UTMCK are discussed. UTMCK...

  • Man Reports Being Shot Twice In Great Smoky Mountains National Park.  // National Parks Traveler;9/7/2012, p1 

    The article reports on a backcountry hiker who was shot twice in the leg while hiking at the Great Smoky Mountains National Park in North Carolina. It mentions that the victim was brought to University of Tennessee Medical Center for treatment. It also notes that the shooting occurred along...

  • Consumer Health Information Library: A Collection Development Strategy. Lewis, Julie; Oelschlegel, Sandy; Earl, Martha // Tennessee Libraries;Sep2011, Vol. 61 Issue 3, p3 

    Conference Abstract: Preston Medical Library has provided a Consumer and Patient Health Information Service since 1989. Plans for relocation and expansion of the library include the addition of a new "Health Information Library" specifically for consumers. This article describes the development...

  • Deals roundup.  // Medical Device Daily;8/6/2008, Vol. 12 Issue 151, p3 

    The article announces that LHC Group of Lafayette, Louisiana, a provider of home nursing services in the U.S. announces that it has acquired 100 percent of the assets of Morristown-Hamblen Home Health and Hospice. According to the article, this acquisition will operate as a subsidiary of LHC...

  • Woman Stabbed On Trail In Great Smoky Mountains National Park.  // National Parks Traveler;6/8/2012, p1 

    The article reports that a 44-year-old woman was stabbed several times while hiking the Gatlinburg Trail in Great Smoky Mountains National Park, situated between Tennessee and North Carolina. As mentioned, victim suffered multiple stab wounds and was taken to the University of Tennessee Medical...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics