Recent reports indicate that early computed tomography (CT) scan within 24 h increases diagnostic accuracy.
Early CT scanning also reduces hospital stay and mortality in patients with an acute abdomen.
Professor O'Dwyer assessed the surgeons' use of a CT scan in patients with an acute abdomen and the impact of this on diagnostic accuracy and mortality.
The investigative team prospectively evaluated patients older than 25 years admitted as an emergency with acute abdominal pain.
The investigators reported that 211 patients fulfilled the inclusion criteria including 129 women and 82 men with a mean age of 62 years.
The correct diagnosis on admission was made in 99 patients.
A CT scan was performed in 81, including 24 who had the scan performed within 24 hours of admission.
|Sensitivity of the CT scan was 86% with 84% accuracy|
The team found that the sensitivity, specificity and accuracy of a CT scan were 86%, 79% and 84%.
The investigators considered a CT scan to have changed clinical management in 40 patients.
The team reported that 15 patients died, and 1 death may have been prevented by an early CT scan.
In addition, 5 patients had a delay in diagnosis of a serious condition, and the team noted that all could have been prevented by early CT scan.
Professor O'Dwyer's team commented, “Selective use of a CT scan increases diagnostic accuracy and improves the management of patients with an acute abdomen.”
“Clinical trials are necessary to assess outcome following selective versus routine use of CT scanning in this group of patients.”