共 42 条
Diagnostic imaging for acute appendicitis: interfacility differences in practice patterns
被引:10
作者:
Michailidou, Maria
[1
]
Casamassima, Maria G. Sacco
[1
]
Karim, Omar
[1
]
Gause, Colin
[1
]
Salazar, Jose H.
[1
]
Goldstein, Seth D.
[1
]
Abdullah, Fizan
[1
,2
]
机构:
[1] Johns Hopkins Univ, Sch Med, Ctr Pediat Surg Clin Trials & Outcomes Res, Div Pediat Surg, Baltimore, MD 21287 USA
[2] Johns Hopkins Univ, Sch Med, Bloomberg Childrens Ctr, Baltimore, MD 21287 USA
关键词:
Appendicitis;
Ultrasonography;
Computed tomography;
Imaging choice;
Pediatric;
PEDIATRIC EMERGENCY-DEPARTMENT;
COMPUTED-TOMOGRAPHY;
RADIATION-EXPOSURE;
SUSPECTED APPENDICITIS;
ABDOMINAL-PAIN;
CHILDREN;
ULTRASOUND;
SCORE;
US;
APPENDECTOMY;
D O I:
10.1007/s00383-015-3669-0
中图分类号:
R72 [儿科学];
学科分类号:
100202 ;
摘要:
To evaluate trends and factors associated with interfacility differences in imaging modality selection in the diagnosis and management of children with suspected acute appendicitis. 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. 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. 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.
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页码:355 / 361
页数:7
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