| Autor: |
Michailidou, Maria, Sacco Casamassima, Maria, Karim, Omar, Gause, Colin, Salazar, Jose, Goldstein, Seth, Abdullah, Fizan |
| Předmět: |
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| Zdroj: |
Pediatric Surgery International; Apr2015, Vol. 31 Issue 4, p355-361, 7p, 2 Charts, 2 Graphs |
| Abstrakt: |
Purpose: To evaluate trends and factors associated with interfacility differences in imaging modality selection in the diagnosis and management of children with suspected acute appendicitis. Methods: We conducted a retrospective review of diagnostic imaging selection and outcomes in patients <20 years of age who underwent appendectomy at a single Children's Hospital from June 2008 to June 2013. These results were then compared with those of referring hospitals. Results: A total of 232 children underwent appendectomy during the study period. Imaging results contributed to diagnostic and management decisions in 95.3 % of cases. CT scan was utilized as first-line imaging in 50 % of cases. CTs were preferentially performed at referring institutions (78 vs. 46 %, p < 0.001). Children were five times more likely to undergo CT at referring institutions (OR = 5.5, CI 3.0-10.2). Adjusting for demographics and Alvarado score, diagnostic imaging choice was independent of patient's clinical status. Conclusion: This study demonstrates that initial presentation to a referring hospital independently predicts the use of CT scan for suspected acute appendicitis. Further efforts should be undertaken to develop a clinical pathway that minimizes radiation exposure in the diagnosis of acute appendicitis, with focus on access to pediatric abdominal ultrasound. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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