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Tomography refers to imaging by sections. Computed tomography (CT) is a non-invasive imaging technique that uses computers to analyze several cross-sectional X-rays to reveal minute details about structures in the body.
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Hospitals provide inpatient and outpatient services. Inpatient services provide care to patients that stay in the hospital for an extended period, ranging from days to months. Examples of inpatient services include intensive care units, hospital wards, or surgeries. Outpatient services provide care to patients who come to a hospital for a diagnostic or treatment but do not stay overnight —for example, diagnostic tests, surgical procedures, or health education.
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Hospitals offer medical and surgical care to the sick and injured, along with accommodation while they recover. At the same time, they also provide outpatient, emergency, psychiatric, and rehabilitation services to meet various community needs. In addition to providing medical care, hospitals also act as hubs for medical research and training. Hospitals use clinical procedures and evidence-based practice standards to deliver patient care. To deliver safe and efficient care, a nurse must stay up...
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DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...
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The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
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Hospital type predicts computed tomography use for pediatric appendicitis.

Kathryn Tinsley Anderson1, Marisa A Bartz-Kurycki1, Mary T Austin2

  • 1McGovern Medical School, University of Texas Health Sciences Center at Houston, Department of Pediatric Surgery, Houston, TX; Center for Surgical Trials and Evidence-Based Practice (C-STEP), Houston, TX.

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Summary

Pediatric appendicitis imaging guidelines favor ultrasound (US) over computed tomography (CT). Presentation at non-children's hospitals strongly predicts CT use, leading to unnecessary radiation exposure in children.

Keywords:
AppendicitisChildComputed tomographyDiagnostic imagingUltrasound

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Area of Science:

  • Pediatric surgery
  • Radiology
  • Medical imaging

Background:

  • Guidelines recommend ultrasound (US) over computed tomography (CT) for pediatric appendicitis.
  • High CT use in children leads to unnecessary radiation exposure.
  • Study evaluates factors influencing preoperative CT use in pediatric appendectomy patients.

Purpose of the Study:

  • To identify variables associated with preoperative computed tomography (CT) use in pediatric appendectomy patients.
  • To analyze imaging practices and trends in pediatric appendicitis care.
  • To understand the impact of hospital type on imaging modality selection.

Main Methods:

  • Retrospective cohort study of 22,333 pediatric patients undergoing appendectomy (2015-2016).
  • Evaluated variables: age, BMI, race/ethnicity, gender, and hospital type (NSQIP-P vs. non-NSQIP-P).
  • Primary outcome: preoperative CT receipt; secondary outcomes: reimaging, trends over time.

Main Results:

  • Ultrasound (US) was the most common initial imaging (52%), followed by CT only (27%).
  • Older age, obesity, female gender, and non-NSQIP-P hospital presentation increased CT odds.
  • Presentation at a non-NSQIP-P hospital was the strongest predictor of CT use (OR 9.4).

Conclusions:

  • Hospital presentation, particularly at non-children's hospitals, is the primary driver of CT use in pediatric appendicitis.
  • National Surgical Quality Improvement Program for Pediatrics (NSQIP-P) hospitals frequently reimage transferred patients and have not reduced CT use.
  • Novel strategies are needed to reduce unnecessary CT imaging across all hospital types.