Staged imaging pathway for the evaluation of pediatric appendicitis.
Pediatr Surg Int
; 32(7): 671-8, 2016 Jul.
Article
en En
| MEDLINE
| ID: mdl-27142212
ABSTRACT
PURPOSE:
Despite significant radiation exposure involved with computed tomography (CT) in evaluation of pediatric appendicitis, its use is still widespread. The goal of this study was to assess the effect of a staged imaging pathway for appendicitis to significantly decrease CT use while maintaining diagnostic accuracy.METHODS:
Chart review was performed for patients evaluated for appendicitis over a 12-month period prior to and after pathway implementation.RESULTS:
There was a significant decrease in CT use as initial imaging after implementation of the pathway; 87.1-13.4 % for evaluations positive for appendicitis (decrease 84.6 %, p < 0.0001) and 82.6-9.2 % for evaluations negative for appendicitis (decrease 88.9 %, p < 0.0001). Use of CT during any point in the evaluation decreased from 91.7 to 25.1 % (decrease 72.6 %, p < 0.0001). The negative appendectomy rate was similar; 5.4 % prior, 4.9 % post (p = 0.955). The missed appendicitis rate did not statistically change; 1.1 % prior, 3.7 % post (p = 0.523). The perforation rate was not statistically altered; 6.5 % prior; 9.8 % post (p = 0.421). 350 less patients underwent CT during the year following the pathway.CONCLUSIONS:
The staged imaging pathway resulted in a marked decrease in children exposed to CT without compromising diagnostic accuracy.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Apendicitis
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Tomografía Computarizada por Rayos X
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Ultrasonografía
Tipo de estudio:
Diagnostic_studies
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Observational_studies
Límite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Newborn
Idioma:
En
Año:
2016
Tipo del documento:
Article