Support for Ultrasound First in Pediatric Appendicitis Diagnosis

Limiting CT use not associated with increased complicated appendicitis diagnoses, longer stays

FRIDAY, Dec. 13, 2013 (HealthDay News) -- During the transition to an ultrasound-first paradigm for imaging acute appendicitis in pediatric patients, there does not seem to be any increase in complicated appendicitis diagnoses or a longer median hospital length of stay (LOS), according to a study published in the December issue of the American Journal of Roentgenology.

Jenna Le, M.D., from Montefiore Medical Center in Bronx, N.Y., and colleagues used a hospital billing database to identify pediatric patients with surgically proven appendicitis from 2005 to 2011. Additionally, utilization of ultrasound and computed tomography (CT) and median hospital LOS were analyzed.

The researchers found that, based on the 804 identified patients, the percentage of patients who underwent CT only showed a downward trend, while the percentage of patients who underwent ultrasound first increased. The percentage of patients who only underwent ultrasound before appendectomy increased moderately over the study period. The percentage of patients with a diagnosis code of complicated appendicitis and the median hospital LOS did not increase significantly over time.

"The transition to an ultrasound-first pathway for the imaging workup of acute appendicitis in children occurred without evidence of a corresponding increase in the proportion of patients with complicated appendicitis or in the median hospital LOS," Le and colleagues conclude.

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