Related Experiment Video

Updated: Jul 2, 2025

Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
07:12

Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta

Published on: September 8, 2023

2.4K

Effect of an Evaluation Algorithm on CT Utilization in Identifying Appendicitis in Children

Kendra L Sikes1, Rebecca J Hart2, Yana Feygin1

  • 1From the Interdisciplinary Research Group.

Pediatric Emergency Care
|February 17, 2024
PubMed

Insights

An appendicitis evaluation algorithm did not significantly change computed tomography (CT) use or length of stay (LOS) in pediatric patients. However, the algorithm was associated with a significant increase in emergency department (ED) length of stay.

Area of Science:

  • Pediatric Emergency Medicine
  • Diagnostic Imaging
  • Clinical Algorithm Implementation

Background:

  • Acute appendicitis is a common surgical emergency in children.
  • Computed tomography (CT) and ultrasound are frequently used for diagnosis, impacting patient care and resource utilization.
  • Standardized evaluation algorithms aim to optimize diagnostic pathways.

Purpose of the Study:

  • To evaluate the impact of an appendicitis evaluation algorithm on CT utilization and length of stay (LOS) in pediatric patients.
  • To determine if the algorithm led to significant changes in diagnostic imaging rates and patient disposition times.

Main Methods:

  • Retrospective chart review of pediatric patients (3-18 years) evaluated for appendicitis.
  • Data collected for 6 months pre- and post-algorithm implementation, with a 3-month washout period.
  • Analysis of CT and ultrasound utilization rates, and emergency department (ED) LOS using statistical tests (chi-squared, Mann-Whitney U).

Main Results:

  • No significant change in CT utilization (25.7% to 24.8%) or ultrasound utilization (59.5% to 59.7%).
  • A significant increase in total ED median LOS was observed (333.50 to 362.00 minutes; P = 0.011).
  • Factors associated with CT use included fever, pain migration, and right lower quadrant tenderness.

Conclusions:

  • The implemented appendicitis evaluation algorithm did not significantly reduce CT utilization or LOS.
  • High rates of equivocal ultrasound findings may contribute to continued CT use and increased LOS.
  • Further refinement of diagnostic strategies is needed to optimize care for pediatric appendicitis evaluations.
Abstract

More Related Videos

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

15.2K
Image Acquisition using Portable Sonography for Emergency Airway Management07:31

Image Acquisition using Portable Sonography for Emergency Airway Management

Published on: September 28, 2022

2.4K

Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

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:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
80
Computed Tomography01:10

Computed Tomography

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.
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
4.5K
Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

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.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
145
Imaging Studies I: CT and MRI01:14

Imaging Studies I: CT and MRI

Introduction: MRI and CT scans are crucial advancements in medical imaging techniques, playing a vital role in diagnosing conditions related to the gastrointestinal (GI) system. Each scan serves distinct purposes, targets specific areas, and requires unique nursing duties.
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
242
Radiological Investigation I: X-ray and CT01:30

Radiological Investigation I: X-ray and CT

Radiological investigations, including X-rays and computed tomography (CT) scans, are critical for diagnosing and evaluating various medical conditions. These imaging techniques provide valuable insights into the body's internal structures, aiding in the detection of abnormalities, assessment of disease progression, and development of treatment strategies. This article delves into two primary radiological investigations, chest X-rays and CT scans, outlining their purpose, procedures, and...
238