Improved diagnostic accuracy in patients with suspected appendicitis

Research output: Contribution to journalArticle

Abstract

Background: Studies during the 1990s showed that it was
possible to reduce the rate of negative appendectomies by using various diagnostic methods. The present study aims to evaluate the effect on diagnostic accuracy of implementation of repeated clinical examination and blood tests in a small county hospital without possibilities of radiological assistance on a 24-hour basis.
Methodology: Prospective study of all appendectomies performed at Ystad General Hospital, Sweden. Leukocyte count and C-reactive protein levels were analysed in all patients. Patients with suspicion of acute appendicitis were admitted for active observation, repeated clinical examination and analyses of leukocyte counts and CRP levels.
Results: 533 appendectomies were performed during 1996-
2000 and compared with the index year 1995. Diagnostic
accuracy increased from 73% to 90% (p<0.01). The rates
of perforations and complications did not change during
the study period, being 12.4% and 5.1%, respectively. Coinciding with the increased accuracy, a drop in the number of appendectomies performed and a longer time interval from admittance to the start of operation was seen.
Conclusion: Through repeated clinical examinations and
blood tests it was prospectively possible to achieve an increase in diagnostic accuracy in patients with suspicion of acute appendicitis without any noticeable side effects.

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Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Surgery

Keywords

  • repeated examinations, diagnostic accuracy, appendicitis, blood tests
Original languageEnglish
Pages (from-to)65-69
JournalAnnals of Gastroenterology
Volume18
Issue number1
Publication statusPublished - 2005
Publication categoryResearch
Peer-reviewedYes