Clinical imaging · 2016
Evaluation for suspected acute appendicitis in the emergency department setting: a comparison of outcomes among three imaging pathways.
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Rosenkrantz Andrew B, Labib Anthony, Ginocchio Luke A, Babb James S
Аннотация
PURPOSE: To compare outcomes of imaging pathways in suspected acute appendicitis.
METHODS: Computerized tomography (CT) alone, ultrasound alone, and ultrasound followed by CT were compared in 570 emergency department (ED) patients with suspected acute appendicitis.
RESULTS: After initial ultrasound, 9.3% of men and 41.0% of women underwent CT. Body mass index (BMI) (P≤.036): 25.3±5.7kg/m(2) (CT), 19.1±3.3kg/m(2) (ultrasound), and 22.4±3.2kg/m(2) (ultrasound then CT). Age (P<.001): 35.9±14.5 years (CT), 12.8±6.2y (ultrasound), and 21.2±9.0 years (ultrasound then CT). ED length-of-stay: 7.0±2.8h (CT), 5.9±2.8h (ultrasound), and 8.4±3.5h (ultrasound then CT). Admission, same-day discharge, appendectomy, pathology positive for appendicitis or complicated appendicitis, 30-day repeat ED visit/hospitalization: no difference between pathways (P=.062-1.00).
CONCLUSION: Ultrasound, selected in patients with lowest age/BMI, had shortest length-of-stay but otherwise similar outcomes.
METHODS: Computerized tomography (CT) alone, ultrasound alone, and ultrasound followed by CT were compared in 570 emergency department (ED) patients with suspected acute appendicitis.
RESULTS: After initial ultrasound, 9.3% of men and 41.0% of women underwent CT. Body mass index (BMI) (P≤.036): 25.3±5.7kg/m(2) (CT), 19.1±3.3kg/m(2) (ultrasound), and 22.4±3.2kg/m(2) (ultrasound then CT). Age (P<.001): 35.9±14.5 years (CT), 12.8±6.2y (ultrasound), and 21.2±9.0 years (ultrasound then CT). ED length-of-stay: 7.0±2.8h (CT), 5.9±2.8h (ultrasound), and 8.4±3.5h (ultrasound then CT). Admission, same-day discharge, appendectomy, pathology positive for appendicitis or complicated appendicitis, 30-day repeat ED visit/hospitalization: no difference between pathways (P=.062-1.00).
CONCLUSION: Ultrasound, selected in patients with lowest age/BMI, had shortest length-of-stay but otherwise similar outcomes.
Предметные рубрики MeSH
Acute DiseaseAdolescentAdultAge FactorsAgedAged, 80 and overAppendectomyAppendicitisAppendixBody Mass IndexChildChild, PreschoolEmergency Service, HospitalFemaleHumansLength of StayMaleMiddle AgedOutcome Assessment, Health CareReproducibility of ResultsRetrospective StudiesTomography, X-Ray ComputedUltrasonographyYoung Adult