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Evaluation of the vomiting infant
L C Foley1, T L Slovis, J B Campbell
1Division of Radiology, Children's Hospital, Denver, Colo.
Insights
Ultrasound before upper gastrointestinal series for infant vomiting increases costs by 95% with no significant reduction in infant morbidity or mortality. This imaging sequence is not cost-effective for evaluating vomiting in infants.
Area of Science:
- Pediatric Imaging
- Gastroenterology
- Diagnostic Radiology
Background:
- Infantile vomiting is a common clinical presentation requiring diagnostic evaluation.
- Upper gastrointestinal series (UGIS) is a standard imaging modality for evaluating vomiting in infants.
- The role of initial ultrasound (US) in this diagnostic pathway is under investigation.
Purpose of the Study:
- To assess the cost-effectiveness, risks, and benefits of using ultrasound followed by UGIS for evaluating vomiting infants.
- To compare the diagnostic yield and clinical outcomes of this imaging sequence versus traditional methods.
Main Methods:
- A 12-month prospective study.
- Inclusion of infants presenting with vomiting.
- Evaluation using an imaging sequence of initial ultrasound followed by UGIS when indicated.
Main Results:
- A 33% reduction in the number of UGIS examinations performed.
- A significant 95% increase in overall imaging costs.
- No meaningful decrease in infant morbidity or mortality observed.
Conclusions:
- Initial ultrasound for infant vomiting evaluation substantially increases healthcare costs.
- The addition of ultrasound does not lead to a clinically significant reduction in morbidity or mortality.
- The current imaging sequence is not cost-effective for the initial evaluation of vomiting in infants.
Abstract:
This 12-month prospective study was undertaken to evaluate the cost, risk, and benefit of ultrasound followed by upper gastrointestinal series for the evaluation of the infant who vomits. Results suggest minimal morbidity from the upper gastrointestinal series, only a 33% reduction in the number of upper gastrointestinal series performed, and a 95% increase in cost if this imaging sequence is used. We conclude that the use of ultrasound for the initial evaluation of vomiting in infants substantially increases the cost with no meaningful decrease in morbidity and mortality.