Ann Surg Treat Res.  2014 Nov;87(5):239-244. 10.4174/astr.2014.87.5.239.

Increasing utilization of abdominal CT in the Emergency Department of a secondary care center: does it produce better outcomes in caring for pediatric surgical patients?

• Kim Y
• Kang G
• Moon SB

• KMID: 2266882
• DOI: http://doi.org/10.4174/astr.2014.87.5.239

Abstract

PURPOSE
The use of abdominal computed tomography (ACT) utilization is increasing to a remarkable extent in the pediatric Emergency Department (ED), but the clinical benefit of increased use of ACT for pediatric surgical patients remains uncertain.
METHODS
A retrospective review was conducted to investigate if, for patients who had visited pediatric ED during the last 5 years, increasing utilization of ACT would increase the detection rate of acute appendicitis, increase the detection rate of surgical conditions other than appendicitis, and decrease the hospital admission rate for surgical conditions.
RESULTS
During the study period, there were 37,918 ED visits; of these, 3,274 (8.6%) were for abdominal pain, 844 (2.2%) had ACT performed. The annual proportional increase of the ACT was statistically significant (1.56% to 2.46%, P = 0.00), but the detection rate of acute appendicitis (3.3% to 5.1%) or other surgical conditions (1.7% to 2.8%) showed no statistically significant changes. Hospital admission rates (5.6% to 6.8%) also showed no significant changes during the study period.
CONCLUSION
Increasing utilization of ACT does not lead to the improved outcomes in caring for pediatric surgical patients visiting the pediatric ED. Careful evaluation for the indication for ACT is needed in the pediatric ED.

Keyword

Abdominal computed tomography; Emergency Department; Pediatric surgical patients; Surgery

MeSH Terms

Abdominal Pain
Appendicitis
Emergency Service, Hospital*
Humans
Retrospective Studies
Secondary Care Centers*
Tomography, X-Ray Computed*

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