Appendicitis in children with acute abdominal pain in primary care, a retrospective cohort study.
Fam Pract
; 38(6): 758-765, 2021 11 24.
Article
em En
| MEDLINE
| ID: mdl-34278425
It can be difficult for general practitioners (GPs) to assess acute abdominal pain in children because they must decide whether it is a common minor problem or an uncommon serious problem. However, unlike their hospital counterparts, GPs must often rely on only the history and examination. We, therefore, wanted to gain a better understanding of how GPs assess abdominal pain and the accuracy of the different parts of their assessment. To do this, we looked back at clinical records for children who presented to a GP with acute abdominal pain between 2010 and 2016. The effect of examination on the probability of detecting appendicitis was calculated for several clinical features, and these were compared with the probability of appendicitis after a full GP assessment. Approximately 1 in 20 of the included children was diagnosed with appendicitis, one in five were initially misdiagnosed, and one in four were ultimately referred to the hospital. We show that some signs and symptoms were not particularly useful for assessment, but when they were, signs detected by the GP examining the patient were more useful than symptoms reported by patients or parents. We recommend that GPs provide safety netting advice and examine the abdomen.
Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Apendicite
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Child
/
Humans
Idioma:
En
Revista:
Fam Pract
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Holanda