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- W2111485448 abstract "OBJECTIVE: Accurate, timely diagnosis of pediatric appendicitis minimizes unnecessary operations and treatment delays. Preoperative abdominal-pelvic computed tomography (CT) scan is sensitive and specific for appendicitis; however, concerns regarding radiation exposure in children obligate scrutiny of CT use. Here, we characterize recent preoperative imaging use and accuracy among pediatric appendectomy subjects. METHODS: We retrospectively reviewed children who underwent operations for presumed appendicitis at a single tertiary-care children’s hospital and examined preoperative CT and ultrasound use with subject characteristics. Preoperative imaging accuracy was compared with postoperative and histologic diagnosis as the reference standard. RESULTS: Most children (395/423, 93.4%) who underwent an operation for appendicitis during 2009–2010 had preoperative imaging. Final diagnoses included normal appendix (7.3%) and perforated appendicitis (23.6%). In multivariable analysis, initial evaluation at a community hospital versus the children’s hospital was associated with 4.4-fold higher odds of obtaining a preoperative CT scan (P = .002), whereas preoperative ultrasound was less likely (odds ratio 0.20; P = .003). Ultrasound and CT sensitivities for appendicitis were diminished for studies performed at community hospitals compared with the children’s hospital. Girls were 4.5-fold more likely to undergo both ultrasound and CT scans and were associated with lower ultrasound sensitivity for appendicitis. CONCLUSIONS: Widespread preoperative imaging did not eliminate unnecessary pediatric appendectomies. Controlling for factors potentially associated with referral bias, a CT scan was more likely to be performed in children initially evaluated at community hospitals compared with the children’s hospital. Broadly-applicable strategies to systematically maximize diagnostic accuracy for childhood appendicitis, while minimizing ionizing radiation exposure, are urgently needed." @default.
- W2111485448 created "2016-06-24" @default.
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- W2111485448 date "2013-01-01" @default.
- W2111485448 modified "2023-09-27" @default.
- W2111485448 title "Use and Accuracy of Diagnostic Imaging by Hospital Type in Pediatric Appendicitis" @default.
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- W2111485448 doi "https://doi.org/10.1542/peds.2012-1665" @default.
- W2111485448 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/3529953" @default.
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