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Trends in diagnostic approaches for pediatric appendicitis: nationwide population-based study
Chih-Cheng Luo1,2, Wen-Kuei Chien3, Chen-Sheng Huang1
1Division of Pediatric Surgery, Department of Surgery, Wan Fang Hospital, Taipei City, Taiwan.
BMC Pediatrics
|November 5, 2017
Summary
Computed tomography (CT) scans for pediatric appendicitis diagnosis increased, but elevated perforation risk, especially in young children. Prompt appendectomy is recommended for typical cases to prevent complications.
Area of Science:
- Pediatric Surgery
- Diagnostic Imaging
- Epidemiology
Background:
- Acute appendicitis is a common surgical emergency in children.
- Accurate and timely diagnosis is crucial to prevent complications like perforation.
Purpose of the Study:
- To evaluate the diagnostic benefits of different imaging methods for pediatric appendicitis in Taiwan.
- To analyze trends in imaging use and appendicitis perforation rates.
Main Methods:
- Nationwide cohort study of 44,529 pediatric patients hospitalized for appendicitis (2003-2012).
- Analysis of ultrasound (US) and computed tomography (CT) utilization.
- Multivariate logistic regression to identify risk factors for perforated appendicitis.
Main Results:
- CT use increased from 3% to 20% between 2003 and 2012.
- Patients diagnosed via CT had a significantly higher odds ratio for perforation (2.744) compared to no imaging.
- Younger children (≤6 years) had a higher risk of perforation (3.094).
Conclusions:
- Increased CT utilization in pediatric appendicitis diagnosis correlates with higher perforation rates, particularly in younger children.
- Prompt appendectomy for uncomplicated appendicitis with typical symptoms is advised to mitigate perforation risk.
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