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Pediatric Surgery International

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01-07-2016 | Original Article

Staged imaging pathway for the evaluation of pediatric appendicitis

Authors: Ming Chien, Arie Habis, Loretto Glynn, Ann O’Connor, Tracie L. Smith, Francis Prendergast

Published in: Pediatric Surgery International | Issue 7/2016

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.

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Title: Staged imaging pathway for the evaluation of pediatric appendicitis
Authors: Ming Chien
Arie Habis
Loretto Glynn
Ann O’Connor
Tracie L. Smith
Francis Prendergast
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Surgery International / Issue 7/2016
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-016-3896-z

ACC 2024 Congress

Springer Medicine

Staged imaging pathway for the evaluation of pediatric appendicitis

Abstract

Purpose

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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