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Routine versus selective computed tomography in non-traumatic acute abdominal pain: meta-analysis of randomised trials

  • Systematic Reviews and Meta-analyses
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Purpose

To compare the routine vs. selective use of computed tomography (CT) in patients presenting with non-traumatic acute abdominal pain (AAP) to a surgical service.

Methods

We conducted a systematic review of literature and meta-analysis of outcomes according to PRISMA statement standards to compare the routine vs. selective use of CT in adult patients presenting with non-traumatic AAP.

Results

Analysis of 722 patients from 4 randomised controlled trials showed no difference between the routine CT and selective CT groups in terms of proportion of correct diagnoses (OR 1.36,95% CI 0.89, 2.07, P = 0.15), mortality (RD 0.03, 95% CI − 0.08, 0.02, P = 0.27] and length of hospital stay (LOS) [MD − 0.26, 95% CI − 2.07, 1.55, P = 0.78).

Conclusions

The routine use of CT does not improve the proportion of correct diagnoses and mortality compared to selective use of CT in adult patients with non-traumatic AAP. The available evidence regarding the influence of routine CT on LOS may be subject to type 2 error. These findings, however, may not apply to the elderly patient with AAP and further studies are required.

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Authors and Affiliations

  1. Department of General Surgery, Glan Clwyd Hospital, Rhyl, Denbighshire, UK

    Shahab Hajibandeh & Sheik Rehman

  2. Department of General Surgery, North Manchester General Hospital, Northern Care Alliance NHS Group, Manchester, UK

    Shahab Hajibandeh, Mohamed Loutfi & Moustafa Mansour

  3. Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK

    Shahin Hajibandeh

  4. Department of General Surgery, Royal Bolton Hospital, Bolton, UK

    Adel Abulkhir & Reza Arsalani Zadeh

Authors
  1. Shahab Hajibandeh
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  2. Mohamed Loutfi
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  3. Shahin Hajibandeh
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  4. Adel Abulkhir
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  5. Sheik Rehman
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  6. Moustafa Mansour
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  7. Reza Arsalani Zadeh
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Contributions

Study conception and design: Shahab H, Acquisition of data: ML, AA, SR, Shahin H, Shahab H. Analysis and interpretation of data: SR, Shahin H, Shahab H. Drafting of manuscript: all the authors. Critical revision of manuscript: all the authors.

Corresponding author

Correspondence to Shahab Hajibandeh.

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The authors declare that they have no conflict of interest.

Ethical approval

Considering the nature of this study, ethical approval was not required.

Human and animal rights

This study is a systematic review with meta-analysis of outcomes which does not include research directly involving human or animal participation.

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Considering the nature of this study, informed consent was not required.

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Hajibandeh, S., Loutfi, M., Hajibandeh, S. et al. Routine versus selective computed tomography in non-traumatic acute abdominal pain: meta-analysis of randomised trials. Langenbecks Arch Surg 405, 283–291 (2020). https://doi.org/10.1007/s00423-020-01884-1

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  • DOI: https://doi.org/10.1007/s00423-020-01884-1

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