Appendicitis outcomes with increasing computed tomographic scanning.

PURPOSE: The purpose of the study was to examine appendicitis outcomes over time as computed tomographic (CT) scanning was incorporated into practice.

BASIC PROCEDURES: Using chart review, appendectomy cases from 1998 to 2004 were analyzed by year for CT scanning rate, delay in treatment, complications, negative appendectomies, and time to surgery. Delay in treatment was defined as discharge from the ED at first visit or more than 20 hours from examination until surgery.

MAIN FINDINGS: Computed tomographic scanning increased from 12.3% in 1998 to 84.4% in 2004. Delay in treatment decreased from 7.8% in 1998 to 3.0% in 2004. Complications decreased from 33.3% in 1998 to 21.3% in 2004. Negative appendectomy rate did not change significantly over time. There was a slight decrease that may have resulted from chances, variation (p=.087) for the line trend. Median time to surgery increased from 250 minutes in 1998 to 426 minutes in 2002, decreasing to 370 minutes by 2004.

CONCLUSION: During the period when CT scanning increased dramatically, delays in treatment and complications decreased significantly, but negative appendectomy rates decreased only slightly, if at all. Median time to surgery increased.