Is There a Correlation between Computed Tomography Scanning of the Acute Abdomen and Associated Surgical Outcomes?
SY Tan, BP Waxman
Hong Kong J Radiol 2015;18:282-6
DOI: 10.12809/hkjr1515301
Objectives: To determine the correlation between computed tomography (CT) scanning in evaluating the acute abdomen and the associated surgical outcome.
Methods: This was a retrospective observational study of 362 patients (198 females, 164 males) admitted with an acute abdomen and underwent surgery to the Acute General Surgery and Colorectal Units at Dandenong District Hospital, Australia, between 1 January 2012 and 30 June 2012. Overall, 100 patients (case group) underwent an inpatient preoperative CT scan whereas 262 patients (control group) did not. Surgical outcome was compared between the case and control groups. In the case group, CT diagnosis was compared with the final surgical diagnosis to generate diagnostic performance parameters.
Results: CT scanning of the acute abdomen had an accuracy of 88%, sensitivity of 88%, and specificity of 100%. The most common cause of the acute abdomen in both case and control groups was appendicitis. The mean length of hospital stay was 4.0 days in the control group and 9.6 days in the case group. Surgical outcome was worst in the case group for patients aged over 31 years, although rates of reoperation and intensive care unit stay were higher in those aged over 60 years in the control group. Differences in surgical outcome were not statistically significant.
Conclusion: CT scanning of patients with an acute abdomen improves diagnostic performance and should be used as an adjunct to clinical evaluation if the benefits outweigh the risks. Surgical outcome in the acute abdomen is not influenced by preoperative CT scanning.
中文摘要
急性腹症的電腦斷層掃描和有關手術結果之間是否相關？
SY Tan, BP Waxman
目的：急性腹症的電腦斷層（CT）掃描和有關手術結果的相關性。
方法：回顧研究於2012年1月1日至6月30日期間，因急腹症須接受手術而被送入澳洲Dandenong區醫院的急性外科和結腸直腸部的362名患者（164男、198女）。其中100人（實驗組）曾於術前接受CT掃描，其餘262人（對照組）未有CT掃描。比較兩組的手術結果及實驗組CT診斷和術後診斷以尋找診斷評價指標。
結果：急性腹部CT掃描的準確度為88%、靈敏度88%、特異性100%。實驗組和對照組最常見的腹痛原因是闌尾炎。平均住院期對照組為4.0天而實驗組為9.6天。實驗組中31歲以上的病人手術結果較差；對照組中60歲以上病人再手術率和入住深切治療病房的比率較實驗組高。兩組的手術結果並無統計顯著差異。
結論：替急腹症患者進行CT掃描可提高診斷準確性。如果進行CT掃描的益處高於風險，應視它為一種臨床輔助工具。但急腹症手術結果未因術前CT掃描而改變。