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EuroSafe Imaging 2019 / ESI-0082
CT imaging for appendicitis - nationwide survey
Congress: EuroSafe Imaging 2019
Poster No.: ESI-0082
Type: EuroSafe Imaging
Keywords: Action 1 - Guidelines, implementation policies, and Clinical Decision Support (ESR iGuide), Action 5 - Performance indicators for radiation protection management, Action 13 - Stakeholder engagement and collaboration, Abdomen, Paediatric, Management, CT, Ultrasound, Audit and standards, Diagnostic procedure, Surgery, Acute, Quality assurance
Authors: G. Pärtan1, D. Wachabauer2; 1Donauspital Wien /Verband für Medizinischen Strahlenschutz in Österreich (VMSÖ) Wien/AT, 2Gesundheit Österreich GmbH Wien/AT
DOI:10.26044/esi2019/ESI-0082

Description of activity and work performed

Research questions:

1. How high is the rate of patients in which a CT has been performed before appendectomy, dependent on the year of discharge from hospital (2009 - 2016) and age group?

2. Does the probability of undergoing a CT as part of an hospital stay for  appendectomy change with the number of FTE held in the hospital by specialists in radiology?

 

Methods:

The Austrian Federal Ministry of Labour, Social Affairs, Health and Consumer Protection commands a database for documentation of diagnoses and services of the austrian hospitals. From this database we retrieved all patients who had an open or laparoscopic appendectomy in an austrian public hospital and werde discharged from their hospital stay during the years 2009 to 2016.

These patients were stratified according to their sex, age group and if they had a CT examination of the abdominal region. It was taken into consideration, if the CT examination was performed before, on the day of the appendectomy or on the day after the appendectomy.

We attempted to correlate these results with the number of radiologists available in the hospitals were the appendectomies were performed. This was extracted from the cost unit statistics of the Austrian hospitals for the years 2009-2016. The number of radiologists was expressed as full-time employment equivalents (FTE).

 

 

Results:

  • During the study period between 2009 and 2016, the number of appendectomies in Austria has fallen by approximately 15%, representing a general tendency for a somewhat more conservative therapeutic approach to appendicitis (Figure 1).
  • Over all age groups, the fraction of patients who received a preoperative CT before appendectomy has increased from approximately 12% in 2009 to 16% in 2016 (Figure 1).
  • The increasing rate of CT examinations during the study period pertains only to patients from 20 years onward, whereas in younger patients it has remained at constant low levels (Figure 2,3).
  • Averaged over the study period, in children and adolescents under the age of 15 years, the rate of CT examinations was only 1,1 - 1,2%, increasing to 3.4% for the age group of 15-19 years. In patients aged 40 years and more, the average rate of CT examinations was 40,6% (Figure 4).
  • There was some - although no significant - tendency for lower CT rates in hospitals with a higher number of radiologists available (Figure 5, 6).

 

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