What standard of care do pre-operative CT scans help achieve in emergency general surgical patients who undergo emergency abdominal surgery in a busy district general hospital in England.
| Abstract: |
- Background: The aim of this study was to assess retrospectively, the accuracy of emergency abdominopelvic Computed Tomography (CT) scans in patients who proceed to emergency laparotomy at a busy acute hospital Trust in England.
- Methods: 205 consecutive patients (112 female and 93 male; mean age 65.9 years; age range 18-99 years) who underwent emergency CT scans prior to proceeding for an emergency laparotomy related to their CT scan were analyzed. The initial CT scan report was used for this assessment against the gold standard of operative findings and in cases found to be discrepant, the addendums were considered for the discussion.
- Results: Overall, the accuracy demonstrated for all CT scans was 89.8% (Kw 0.83, p<0.001; x2 821.31, p=0.00001, 15df) showing optimal agreement between CT and operative findings. The highest diagnostic accuracy was in scans reported by gastro-intestinal (GI) radiologists at 92.9% (13/14), while the lowest accuracy was found in scans outsourced and reported via teleradiology by non-trust radiologists at 80% (24/30).
- Conclusion: Emergency CT scans performed prior to emergency laparotomies have a high accuracy, increase the diagnostic confidence and contribute to a good standard of care offered to patients.
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- Analysis of existing data
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