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Value Assessment of Evolving Pediatric Appendicitis Imaging Strategies Between 2004 and 2018

Shireen E Hayatghaibi1, Andrew T Trout2, Jonathan R Dillman3

  • 1Department of Radiology, Texas Children's Hospital, Houston, Texas; University of Texas, School of Public Health, Houston, Texas.

Journal of the American College of Radiology : JACR
|September 1, 2020
PubMed

Insights

Diagnostic imaging for pediatric appendicitis has shifted, with decreased CT scans and increased ultrasound use. This change improved healthcare value without negatively impacting negative appendectomy rates.

Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging
  • Health Services Research

Background:

  • Appendicitis is a common surgical emergency in children.
  • Diagnostic imaging plays a crucial role in the diagnosis of pediatric appendicitis.
  • Variations in imaging utilization and their impact on outcomes are important to understand.

Purpose of the Study:

  • To evaluate trends in diagnostic imaging utilization for pediatric appendicitis.
  • To assess changes in the negative appendectomy rate over time.
  • To analyze imaging practices in US children's hospitals from 2004 to 2018.

Main Methods:

  • Retrospective study using the Pediatric Health Information System (PHIS) database.
  • Inclusion of pediatric patients (0-17 years) who underwent appendectomy.
  • Analysis of imaging modalities (CT, ultrasound, radiography, MRI) and negative appendectomy rates.

Main Results:

  • CT utilization decreased significantly, while ultrasound use increased substantially.
  • Radiography use remained stable, and MRI use showed a slight increase.
  • The negative appendectomy rate showed a slight decrease over the study period.

Conclusions:

  • A notable shift in imaging modalities for pediatric appendicitis occurred between 2004 and 2018.
  • Increased ultrasound use and decreased CT use likely enhanced healthcare value.
  • These imaging trends did not adversely affect negative appendectomy rates in children.
Abstract

Keywords:
Appendicitisoutcomesultrasound

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