October 7, 2008

CT Scans Change Some ER Treatment Plans

A U.S. study shows computerized tomography scans change the initial ER treatment plans of more than one-quarter of all suspected appendicitis patients.

University of Washington Harborview Medical Center researchers in Seattle studied 100 adult patients admitted to the center's emergency department for symptoms of appendicitis. The treatment plans of those patients were assessed before and after CT scans and then compared.

Results showed "treatment plans changed in 29 percent of patients as a result of CT (and) in many instances, CT ruled out appendicitis when the treatment plan prior to the scan was surgical consultation, eliminating the potential for unnecessary surgery on patients with a normal appendix," said Dr. Robert Nathan, lead author of the study.

"The data suggest that CT can be withheld in patients in whom emergency clinicians rate the likelihood of appendicitis as unlikely, but that CT findings are often of benefit when appendicitis is judged to be very likely," said Dr. Nathan.

"Patients can be assured that CT scanning of the appendix adds value to therapeutic decision making, thereby improving their care," said Nathan.

The study appears in the American Journal of Roentgenology.