Diagnóstico de la apendicitis y su variación en el tiempo

Abstract

Background: Technology changed progresively diagnosis of appendicitis, who is a challenge. The aims of our study were to a) Describe the variation of the diagnosis of appendicitis over time and b) Evaluate the rate of negative appendectomies with the use of different diagnostic tools. Methods: Retrospective database review. Description of the variation of the diagnosis of appendicitis in time of 1645 patients in whom an appendectomy was performed in a health institution in Bogota from January 2011 to December 2016. In adition, The rate of negative appendectomy was also evaluated with the use of different diagnostic tools. Results: The number of patients diagnosed by the clinical and ultrasound findings decreased in time, while the diagnosis by tomography increased. The rate of negative appendectomies with clinical evaluation was 14.5%, abdominal ultrasound 75% and tomography 5.3%. The number of appendectomies decreased from 362 to 215 in six years. Discussion: The availability of technology, its easy realization and deliberate use in the emergency room, have gradually transformed the diagnosis of appendicitis, decreasing the number of patients operated and the rate of negative appendectomies. Conclusions: The results of this study suggest that a) the use of tomography has increased in time, decreasing the diagnosis of clinical and ultrasound findings, and b) the number of negative appendectomies was lower with the use of ultrasound and tomography.

Comparación de los desenlaces clínicos con cuatro técnicas de apendicetomía laparoscópica tras la implementación de políticas de reúso de dispositivos médicos

“…análisis comparativo, dado que permite analizar el uso de diferentes recursos tecnológicos utilizados por un grupo de cirujanos en una institución de salud colombiana para el manejo de una patología altamente prevalente. Aunque existen estudios preliminares en poblaciones equivalentes 31,32 , teniendo en cuenta las características propias del sistema sanitario, este es el primer estudio colombiano que compara diferentes recursos tecnológicos en el contexto de las políticas de reúso de dispositivos médicos instauradas en el país. De igual forma, este estudio contribuye al análisis de la calidad de atención y aporta al diseño de estrategias de mejoramiento interno.…”