S-Space College of Medicine/School of Medicine (의과대학/대학원) Dept. of Medicine (의학과) Theses (Ph.D. / Sc.D._의학과)
Diagnostic imaging utilization in cases of acute appendicitis: multi-center experience
충수염 환자의 진단 영상 검사 사용 실태에 관한 다기관 연구
- 의과대학 의학과
- Issue Date
- 서울대학교 대학원
- 학위논문 (박사)-- 서울대학교 대학원 : 의학과, 2015. 2. 이경호.
- Introduction: The purpose of this cross-sectional study was to measure imaging utilization rates and the negative appendectomy rate (NAR) in metropolitan Seoul, Korea.
Methods: The study included 2321 adolescents and adults (≥ 15 years
median [interquartile range] age, 37 [27-50] years
46.7% female) undergoing appendectomy in 2011 at eight tertiary and three secondary hospitals.
Results: Imaging utilization rate was 99.7% (95% confidence interval, 99.4%-99.9%). CT and ultrasonography utilization rates as an initial imaging modality were 93.1% (92.0%-94.1%), and 6.5% (5.6%-7.6%), respectively. The NAR in patients undergoing CT only, complementary ultrasonography following CT, ultrasonography only, and complementary CT following ultrasonography were 3.3% (2.6%-4.1%), 27% (14%-44%), 9% (4%-16%), and 8% (2%-20%), respectively. The use of ultrasonography instead of CT as the initial imaging modality was significantly associated with higher NAR (adjusted odds ratio [AOR], 2.28 [1.22-4.27]
risk difference, 4.4 [0-8.8] percentage points), however, the population attributable risk was 0.3 [0-0.6] percentage points.
Conclusions: We observed a very high CT utilization rate and a low NAR in metropolitan Seoul. Although the use of CT was significantly associated with the lower NAR, CT utilization rate already has reached the level that increase in CT utilization from the status quo would hardly decrease the NAR further.
Tomography, X-ray computed
Student number: 2013-30543