Impact of Transcervical Ultrasound for the Diagnosis of Pediatric Peritonsillar Abscesses on Emergency Department Performance Measures
| Autor: | Brian K. Reilly, James M. Chamberlain, Joanna S. Cohen, Eva I Rubio, Marc Delaney, Xian Zhao, Kristen Breslin |
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| Rok vydání: | 2019 |
| Předmět: |
Pediatric emergency
Male medicine.medical_specialty Palatine Tonsil Computed tomography 030218 nuclear medicine & medical imaging Cohort Studies 03 medical and health sciences 0302 clinical medicine medicine Humans Radiology Nuclear Medicine and imaging Peritonsillar Abscess Child Retrospective Studies Ultrasonography 030219 obstetrics & reproductive medicine Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Ultrasound Reproducibility of Results Retrospective cohort study Imaging study Emergency department Confidence interval Surgery Female business Emergency Service Hospital Tomography X-Ray Computed |
| Zdroj: | Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in MedicineReferences. 39(4) |
| ISSN: | 1550-9613 |
| Popis: | Objectives To evaluate the impact of transcervical ultrasound (US) as the initial imaging study for suspected peritonsillar abscesses (PTAs) on pediatric emergency department (ED) throughput measures. Methods A retrospective cohort study of patients evaluated for suspected PTAs between January 2009 and April 2017 was conducted. We compared the ED length of stay (LOS) before and after implementation of transcervical US to diagnose a PTA. The balancing measure was the rate of return visits within 2 weeks. Results There were 387 eligible patients over the study period. A total of 101 patients were evaluated for PTAs with computed tomography and 286 with US. The mean LOS was significantly less for patients who had US (347 minutes; 95% confidence interval [CI], 330, 364 minutes) compared to computed tomography (426 minutes; 95% CI, 392, 459 minutes), with an absolute difference of 79 minutes (95% CI, 44, 113 minutes). Patients who were evaluated with US did not have an increased rate of return visits (5.9% versus 8.0%; P = .66). Conclusions The introduction of transcervical US was associated with a decrease of greater than 1 hour in the ED LOS for patients with suspected PTAs. Given the better radiation profile of US and no increase in the rate of return visits after its implementation, we propose the adoption of a transcervical US-first approach for the diagnosis of PTAs in pediatrics. |
| Databáze: | OpenAIRE |
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