CT Use Up for Children With Abdominal Pain Seen in ER

From 1998-2008, no change in ultrasound/X-ray use, appendicitis diagnosis, hospital admission

MONDAY, Oct. 8 (HealthDay News) -- For children presenting to the emergency department with abdominal pain, there was a dramatic increase in computed tomography (CT) use from 1998 to 2008, according to a study published online Oct. 8 in Pediatrics.

Jahan Fahimi, M.D., M.P.H., from Highland Hospital in Oakland, Calif., and colleagues examined trends in and factors associated with CT use among children presenting to the emergency department with abdominal pain. Data were analyzed from emergency department patients under the age of 19 years with abdominal pain participating in the National Hospital Ambulatory Medical Care Survey from 1998 to 2008. Patient demographic and hospital characteristics and outcomes related to imaging, hospital admission, and diagnosis of appendicitis were assessed.

The researchers found that 6.0 percent of all pediatric emergency department visits were for abdominal pain. From 1998 to 2008 there was a significant rise in the proportion of these patients with CT use, from 0.9 to 15.4 percent, with no change noted during that period in ultrasound/radiograph use, diagnosis of appendicitis, or hospital admission. Black children were significantly less likely to undergo a CT scan compared with white children (odds ratio, 0.50), whereas older and male patients were more likely to have a CT scan. Children who were admitted had much higher odds of undergoing a CT scan (odds ratio, 4.11). From 2006 to 2008 there was a plateau in CT use.

"Although these results suggest that emergency providers increasingly rely on this testing modality, neither the reason for, nor the benefits of, this trend is clear," the authors write.

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