[Acute appendicitis. Usefulness of a evidence-based critical pathway]

Area of Science:

• Pediatric Surgery
• Clinical Pathways
• Appendicitis Management

Background:

• Acute appendicitis is a common surgical emergency in children.
• Standard treatment protocols may vary, impacting resource utilization and patient outcomes.
• Optimizing care pathways is crucial for efficient pediatric healthcare.

Purpose of the Study:

• To evaluate the effectiveness of an evidence-based clinical pathway for pediatric acute appendicitis.
• To compare outcomes between patients managed via a clinical pathway and those receiving conventional care.
• To assess the impact on hospitalization duration, antibiotic use, and complication rates.

Main Methods:

• A prospective study comparing 114 pediatric patients (3-14 years) on a clinical pathway with 115 historical controls treated conventionally.
• Key outcome measures included length of hospital stay, antibiotic doses, and complication rates.
• Statistical analysis compared demographic and clinical data between the two groups.

Main Results:

• No significant differences were observed in age, gender, or appendicitis type between groups.
• The clinical pathway group experienced a significantly shorter hospital stay (4.34 vs. 5.33 days) and reduced antibiotic doses (11.17 vs. 16.13).
• Major complications were lower in the pathway group (6 vs. 16), though not statistically significant (p=0.09).

Conclusions:

• Clinical pathways are effective and safe tools for managing pediatric acute appendicitis.
• Implementation leads to decreased hospitalization length and antibiotic administration.
• This approach maintains the quality of care for children with appendicitis.