Imaging Approach to the Diagnosis of Acute Appendicitis in a Group of Teaching Hospitals with 24/7 In-house Availability of Ultrasound Technologist: Effect of Timing of Request on Imaging Modality
| Autor: | Mostafa Atri, Babak Maghdoori, Sara Maghdoori, Shadman Islam, Hassan Alzahrani |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Personnel Staffing and Scheduling Computed tomography 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Humans Medicine Radiology Nuclear Medicine and imaging Hospitals Teaching Retrospective Studies Ultrasonography Modality (human–computer interaction) medicine.diagnostic_test business.industry Ultrasound General Medicine Requisition Appendicitis medicine.disease 030220 oncology & carcinogenesis Acute Disease Acute appendicitis Female Radiology Tomography X-Ray Computed business |
| Zdroj: | Canadian Association of Radiologists Journal. 69:311-315 |
| ISSN: | 1488-2361 0846-5371 |
| DOI: | 10.1016/j.carj.2018.03.002 |
| Popis: | Purpose The study sought determine effect of requisition timing on the initial-choice imaging modality in appendicitis evaluation. Methods This was an institutional review board–approved retrospective study, encompassing 3 University of Toronto teaching hospitals, offering 24/7 radiology coverage. All surgically proven appendicitis cases, from 2012-2014, were included and presurgical ultrasound (US) or computed tomography (CT) reports were analysed. Examinations were all requested by the emergency department, performed by the same technologists and reviewed or finalized by the same radiology group (residents fellows or attending). Two coverage categories, namely regular hours (8 am-5 pm, Monday-Friday) or after hours (5 pm-8 am, Monday-Friday and weekends) were compared. The percentage of the starting modality (US or CT), the rate of CT following an indeterminate US, and the sensitivity of each modality was compared between the 2 categories, utilising Mann-Whitney U and chi-square tests. Results Presurgical US or CT studies of 494 patients, from February 2012-August 2014, were evaluated. Regular-hours and after-hours coverage demonstrated 174 (89:85 women:men) and 320 (141:179 women:men; P < .04) patients. The average age, 37.9 ± 17.1 women versus 35.2 ± 13.7 men was not statistically different ( P = .8). Regular hours included 89 of 174 (51.1%) of US-only examinations, 50 of 174 (29%) of CT-only examinations, and 35 of 174 (20%) of US examinations followed by CT examinations. After hours included 147 of 320 (46%) of US-only examinations, 147 of 320 (46%) of CT-only examinations, and 26 of 320 (8%) of US examinations followed by CT examinations ( P < .001). The total diagnostic sensitivities for US and CT were 86% (81% regular hours, 90% after hours; P = .041) and 99.2% (100% regular hours, 99% after hours; P > .05), respectively. Conclusions US was less utilised in acute appendicitis detection after hours, although its diagnostic sensitivity was better than regular-hours coverage. |
| Databáze: | OpenAIRE |
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