Examining the relevance of the physician's clinical assessment and the reliance on computed tomography in diagnosing acute appendicitis.
Am J Surg
; 205(4): 452-6, 2013 Apr.
Article
em En
| MEDLINE
| ID: mdl-23388421
ABSTRACT
BACKGROUND:
The aim of this study was to examine the relevance of clinical assessment in diagnosing appendicitis in the current medical environment, in which routine use of computed tomography (CT) has become the norm.METHODS:
A retrospective review was conducted, analyzing patient demographics, Alvarado clinical assessment scoring, and radiologic and pathologic results.RESULTS:
A total of 664 patients were identified. Higher Alvarado scores were significantly associated with pathologically confirmed appendicitis (low, 87%; moderate, 92%; high, 96%; P = .05). As clinical assessment scores increased, use of CT decreased significantly (low, 97%; moderate, 85%; high, 79%; P = .01). The negative appendectomy rate for patients with clinical assessments consistent with appendicitis was 4%, compared with 3% associated with CT. Regardless of assessment scores, 82% of the cohort underwent CT. From a random sample of 100 charts, 87% of initial emergency department plans stratified disposition on the basis of the results of CT.CONCLUSIONS:
Although physical examination remains crucial, CT has become the primary modality dictating care of patients with presumed appendicitis.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
1_ASSA2030
Problema de saúde:
1_sistemas_informacao_saude
Assunto principal:
Apendicite
/
Exame Físico
/
Tomografia Computadorizada por Raios X
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
Aspecto:
Patient_preference
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Am J Surg
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Estados Unidos