J Korean Med Sci.  2022 Jan;37(4):e27. 10.3346/jkms.2022.37.e27.

Relationship Between Appendectomy Incidence and Computed Tomography Scans Based on Korean Nationwide Data, 2003–2017

• Park KB
• Hong J
• Moon JY
• Jung J
• Seo HS

• KMID: 2525008
• DOI: http://doi.org/10.3346/jkms.2022.37.e27

Abstract

Background
Advances in medicine and changes in the medical environment can affect the diagnosis and treatment of diseases. The main purpose of the present study was to investigate whether the difference in accessibility to diagnosis and treatment facilities influenced the occurrence of appendectomy in Korea.
Methods
We collected data on 183,531 appendectomy patients between 2003 and 2017 using the National Health Insurance Services claims. Retrospective analysis of relationship between the age-standardized rate (ASR) of appendectomy and clinical variables affecting medical accessibility was performed. Pearson’s correlation analyses were used.
Results
The incidence of appendectomy decreased from 30,164 cases in 2003 to 7,355 cases in 2017. The rate of computerized tomography (CT) scans for diagnosis of appendicitis increased from 4.73% in 2003 to 86.96% in 2017. The ASR of appendectomy in uncomplicated and complicated appendicitis decreased from 48.71 in 2005 to 13.40 in 2010 and 8.37 in 2005 to 2.96 in 2009, respectively. The ASR of appendectomy was higher in the high-income group. The proportion and ASR of appendectomy in older age group increased steadily with years. The total admission days continued to decrease from 6.02 days in 2003 to 4.96 days in 2017.
Conclusion
The incidence of appendectomy was seemingly associated with the rate of CT scan. In particular, the incidence of appendectomy in uncomplicated appendicitis was markedly reduced. Through enhanced accessibility to CT scans, accurate diagnosis and treatment of appendicitis can be facilitated.

Keyword

Appendectomy; Epidemiology; Computed Tomography; Medical Accessibility; Nationwide

Figure

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  Fig. 1 Incidence of appendectomy with CT. Coefficient of correlation between incidence of CT and CT rate was 0.8029 (P value < 0.001).CT = computerized tomography.

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  Fig. 2 Alterations of ASR of simple and perforated appendectomy.ASR = age-standardized rate, AU = appendectomy for uncomplicated appendicitis, AC = appendectomy for complicated appendicitis.

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  Fig. 3 Alterations of ASR based on (A) age and (B) income.ASR = age standardized rate.

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  Fig. 4 Trend of total hospital admission days.

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