Thirty-Day Outcomes in Ultrasound Versus CT-Only Imaging in Obese Adults With Acute Appendicitis.
4 affiliations
- 1Radiology, Drexel University College of Medicine, Philadelphia, USA.
- 2Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, USA.
- 3Radiology, Florida State University College of Medicine, Pensacola, USA.
- 4Molecular Biology & Interprofessional Chronic Care, Drexel University College of Medicine, Philadelphia, USA.
Abstract
Background Acute appendicitis is one of the most common surgical emergencies affecting people worldwide. Current guidelines suggest imaging with an immediate computed tomography (CT) scan as the gold standard imaging pathway. However, emerging research has suggested that the addition of an ultrasound (US) can play a role in the diagnosis of acute appendicitis. In this study, we wanted to see if US as an adjunct to the existing imaging pathway of a CT scan had any improvement in 30-day outcomes in adult obese patients. Method Using data gathered from real patients using the TriNetX Global Collaborative Network, we conducted a retrospective cohort study on adult obese patients (BMI ≥ 30) with acute appendicitis who were diagnosed by US, with or without a CT scan, versus those who received only a CT scan. In order to balance for possible confounding variables, propensity score matching (1:1) was used to match for common demographic information and comorbidities known to worsen surgical outcomes (hypertension, diabetes mellitus, BMI). The study's primary outcome was emergency room revisit rate after their initial visit. Secondary outcomes included peritoneal abscess, perforation, and peritonitis. All outcomes were measured at 30 days after the acute appendicitis diagnosis. Results After propensity score matching, 968 patients were deemed eligible for analysis, with 484 patients within each cohort. There were no detectable statistical differences between these groups after matching for patient demographics and comorbidities. Those who underwent a US did not show significant differences in outcomes compared to those who received a CT scan only. The rates of emergency room revisits were similar between the US and CT scan groups, at 11.98% and 13.64%, respectively (RR = 0.879, p = 0.44). For secondary outcomes, no statistical difference was found for the risk of peritoneal/abdominal abscess (RR = 0.69, p = 0.16), perforation (RR = 1.32, p = 0.35), or peritonitis (RR = 0.90, p = 0.59). Conclusion Our study demonstrated no statistically significant difference in outcomes for adult obese patients diagnosed with acute appendicitis who received an ultrasound, compared to those who received a CT scan only.
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BibTeX
@article{mckinnerney2026thirtyday,
title = {{Thirty-Day Outcomes in Ultrasound Versus CT-Only Imaging in Obese Adults With Acute Appendicitis.}},
author = {Joseph McKinnerney and Jason Yan and Harpreet Grewal and Vivek Joshi},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116517},
url = {https://europepmc.org/article/MED/42898523},
note = {CC BY},
}
RIS
TY - JOUR
TI - Thirty-Day Outcomes in Ultrasound Versus CT-Only Imaging in Obese Adults With Acute Appendicitis.
AU - Joseph McKinnerney
AU - Jason Yan
AU - Harpreet Grewal
AU - Vivek Joshi
PY - 2026
DA - 2026/09/18
JO - Cureus
DO - 10.7759/cureus.116517
UR - https://europepmc.org/article/MED/42898523
AB - Background Acute appendicitis is one of the most common surgical emergencies affecting people worldwide. Current guidelines suggest imaging with an immediate computed tomography (CT) scan as the gold standard imaging pathway. However, emerging research has suggested that the addition of an ultrasound (US) can play a role in the diagnosis of acute appendicitis. In this study, we wanted to see if US as an adjunct to the existing imaging pathway of a CT scan had any improvement in 30-day outcomes in adult obese patients. Method Using data gathered from real patients using the TriNetX Global Collaborative Network, we conducted a retrospective cohort study on adult obese patients (BMI ≥ 30) with acute appendicitis who were diagnosed by US, with or without a CT scan, versus those who received only a CT scan. In order to balance for possible confounding variables, propensity score matching (1:1) was used to match for common demographic information and comorbidities known to worsen surgical outcomes (hypertension, diabetes mellitus, BMI). The study's primary outcome was emergency room revisit rate after their initial visit. Secondary outcomes included peritoneal abscess, perforation, and peritonitis. All outcomes were measured at 30 days after the acute appendicitis diagnosis. Results After propensity score matching, 968 patients were deemed eligible for analysis, with 484 patients within each cohort. There were no detectable statistical differences between these groups after matching for patient demographics and comorbidities. Those who underwent a US did not show significant differences in outcomes compared to those who received a CT scan only. The rates of emergency room revisits were similar between the US and CT scan groups, at 11.98% and 13.64%, respectively (RR = 0.879, p = 0.44). For secondary outcomes, no statistical difference was found for the risk of peritoneal/abdominal abscess (RR = 0.69, p = 0.16), perforation (RR = 1.32, p = 0.35), or peritonitis (RR = 0.90, p = 0.59). Conclusion Our study demonstrated no statistically significant difference in outcomes for adult obese patients diagnosed with acute appendicitis who received an ultrasound, compared to those who received a CT scan only.
SN - 2168-8184
ER -