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. Published by Elsevier Inc.
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. Published by Elsevier Inc.
Authors: Massimo Sartelli; Gian L Baiocchi; Salomone Di Saverio; Francesco Ferrara; Francesco M Labricciosa; Luca Ansaloni; Federico Coccolini; Deepak Vijayan; Ashraf Abbas; Hariscine K Abongwa; John Agboola; Adamu Ahmed; Lali Akhmeteli; Nezih Akkapulu; Seckin Akkucuk; Fatih Altintoprak; Aurelia L Andreiev; Dimitrios Anyfantakis; Boiko Atanasov; Miklosh Bala; Dimitrios Balalis; Oussama Baraket; Giovanni Bellanova; Marcelo Beltran; Renato Bessa Melo; Roberto Bini; Konstantinos Bouliaris; Daniele Brunelli; Adrian Castillo; Marco Catani; Asri Che Jusoh; Alain Chichom-Mefire; Gianfranco Cocorullo; Raul Coimbra; Elif Colak; Silvia Costa; Koray Das; Samir Delibegovic; Zaza Demetrashvili; Isidoro Di Carlo; Nadezda Kiseleva; Tamer El Zalabany; Mario Faro; Margarida Ferreira; Gustavo P Fraga; Mahir Gachabayov; Wagih M Ghnnam; Teresa Giménez Maurel; Georgios Gkiokas; Carlos A Gomes; Ewen Griffiths; Ali Guner; Sanjay Gupta; Andreas Hecker; Elcio S Hirano; Adrien Hodonou; Martin Hutan; Orestis Ioannidis; Arda Isik; Georgy Ivakhov; Sumita Jain; Mantas Jokubauskas; Aleksandar Karamarkovic; Saila Kauhanen; Robin Kaushik; Alfie Kavalakat; Jakub Kenig; Vladimir Khokha; Desmond Khor; Dennis Kim; Jae I Kim; Victor Kong; Konstantinos Lasithiotakis; Pedro Leão; Miguel Leon; Andrey Litvin; Varut Lohsiriwat; Eudaldo López-Tomassetti Fernandez; Eftychios Lostoridis; James Maciel; Piotr Major; Ana Dimova; Dimitrios Manatakis; Athanasio Marinis; Aleix Martinez-Perez; Sanjay Marwah; Michael McFarlane; Cristian Mesina; Michał Pędziwiatr; Nickos Michalopoulos; Evangelos Misiakos; Ali Mohamedahmed; Radu Moldovanu; Giulia Montori; Raghuveer Mysore Narayana; Ionut Negoi; Ioannis Nikolopoulos; Giuseppe Novelli; Viktors Novikovs; Iyiade Olaoye; Abdelkarim Omari; Carlos A Ordoñez; Mouaqit Ouadii; Zeynep Ozkan; Ajay Pal; Gian M Palini; Lars I Partecke; Francesco Pata; Michał Pędziwiatr; Gerson A Pereira Júnior; Tadeja Pintar; Magdalena Pisarska; Cesar F Ploneda-Valencia; Konstantinos Pouggouras; Vinod Prabhu; Padmakumar Ramakrishnapillai; Jean-Marc Regimbeau; Marianne Reitz; Daniel Rios-Cruz; Sten Saar; Boris Sakakushev; Charalampos Seretis; Alexander Sazhin; Vishal Shelat; Matej Skrovina; Dmitry Smirnov; Charalampos Spyropoulos; Marcin Strzałka; Peep Talving; Ricardo A Teixeira Gonsaga; George Theobald; Gia Tomadze; Myftar Torba; Cristian Tranà; Jan Ulrych; Mustafa Y Uzunoğlu; Alin Vasilescu; Savino Occhionorelli; Aurélien Venara; Andras Vereczkei; Nereo Vettoretto; Nutu Vlad; Maciej Walędziak; Tonguç U Yilmaz; Kuo-Ching Yuan; Cui Yunfeng; Justas Zilinskas; Gérard Grelpois; Fausto Catena Journal: World J Emerg Surg Date: 2018-04-16 Impact factor: 5.469
Authors: Claus W Schildberg; Kathrin Reissig; Richard Hunger; Christoph Paasch; Rosi Stillger; René Mantke Journal: J Clin Med Date: 2022-08-02 Impact factor: 4.964