CT Scans Reduce Unnecessary Appendix Surgeries
Every year, some 250,000 new cases of appendicitis develop in the U.S., requiring hospital admissions totaling more than one million patient days. Yet as many as 47 percent of the clinical diagnoses of acute appendicitis are wrong.1 Recent studies have shown that medical imaging can improve clinical judgment and reduce unneeded surgeries – in the process, reducing costs.
- A study published in the New England Journal of Medicine found that routine use of CT scans in 100 consecutive cases of suspected appendicitis prevented 13 unneeded appendectomies (for a savings of $47,281) and 50 unneeded inpatient days (for a savings of $20,250.) After the cost of the CT studies for the 100 patients was subtracted, the total savings per patient overall was $447.2 Click here to view the study
Effect of CT on Treatment and Resource Use for
100 Patients with Suspected Appendicitis |
| Treatment Change |
Dollar Value |
| Savings |
|
| Avoided unnecessary appendectomies |
$47,281 |
| Avoided observation for 1 day before appendectomy |
$8,505 |
Avoided observation for 1 day before treatment for CT
diagnosed alternative condition |
$4,455 |
| Avoided observation for 1 day before discharge |
$7,290 |
| Costs |
|
| Appendiceal CT examinations |
$22,800 |
| Overall Savings |
$44,731 |
| Source: "Effect of Computed Tomography of the Appendix on Treatment of Patients and Use of Hospital Resources," by Patrick M. Rao, James T. Rhea, Robert A Novelline, Amy A. Mostafavi, and Charles J. McCabe, New England Journal of Medicine, Volume 338; pp. 141-146, January 15, 1998. |
- A study in Pediatrics found that using CT to diagnose appendicitis in children would reduce the number of unneeded operations and the number of days of inpatient observation prior to a diagnosis. Overall, total per patient costs would fall.3 Click here to view the study
- At the same time, using CT would also reduce the amount of time to appendectomy for those children who truly suffered from appendicitis. The authors conclude that, "Obtaining CT scans on all children who are candidates for inpatient observation for suspected appendicitis would reduce both morbidity and cost."
CT = Less Cost, Unneeded Surgery for Kids
Outcomes, Costs for CT Strategies vs. Current Practice |
| |
Inpatient Observation Days |
Missed Appendicitis |
Total Operations |
Negative Laparotomies |
Per Patient Cost |
| Current Strategy |
487 |
3 |
112 |
26 |
$5,831 |
| CT/then send home |
0 |
3 |
93 |
7 |
$3,813 |
| CT/then admit to hospital |
363 |
0 |
93 |
7 |
$5,277 |
| CT/WBC/then admit to hospital |
370 |
2 |
97 |
11 |
$5,140 |
| As shown in the left column, the current treatment strategy was compared to three strategies in which CT use was mandatory. The authors concluded that each of the CT stategies would have reduced the number of observation days, operations, negative laparotomies, and cost per patient. Source: “Effect of Computed Tomography on Patient Management and Costs in Children with Suspected Appendicitis,” Pediatrics, September 1999. |
1 "More Precision in Diagnosing Appendicitis," McColl I, New England Journal of Medicine, Vol. 338; 190-191, January 15, 1998.
2 "Effect of Computed Tomography of the Appendix on Treatment of Patients and Use of Hospital Resources," Patrick M. Rao, James T. Rhea, Robert A Novelline, Amy A. Mostafavi, and Charles J. McCabe, The New England Journal of Medicine, Volume 338; pp. 141-146, January 15, 1998.
3 "Effect of Computed Tomography on Patient Management and Costs in Children with Suspected Appendicitis," Barbara M. Garcia Pena, George A. Taylor, Dennis P. Lunc, and Kenneth D. Mandl, Pediatrics, Vol. 104, No. 3, pp 440-446, September 1999.
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