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Rates of Concurrent Computed Tomography Imaging Following Ultrasound for Pediatric Patients With Appendicitis
Jack H Scaife1, Stephanie E Iantorno1, Brian T Bucher1
1Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
The Journal of Surgical Research
|August 5, 2024
Summary
Increased ultrasound use for appendicitis diagnosis correlates with less computed tomography use. However, disparities exist, with White children and those from lower socioeconomic backgrounds more likely to receive concurrent imaging.
Area of Science:
- Pediatric imaging
- Radiology
- Emergency medicine
Background:
- Ultrasound (US) is recommended for appendicitis evaluation to reduce radiation exposure.
- The relationship between US and computed tomography (CT) use for appendicitis diagnosis requires further clarification.
Purpose of the Study:
- To investigate the correlation between increased ultrasound utilization and the rate of CT scans for pediatric acute appendicitis.
- To analyze patient demographics and socioeconomic factors associated with concurrent imaging rates.
Main Methods:
- Retrospective cohort study using the 2019 Nationwide Emergency Department Sample.
- Analysis of 23,976 pediatric appendicitis cases across 485 hospitals.
- Generalized ordinal logistic regression with inverse probability weighting to assess imaging utilization.
Main Results:
- Higher US utilization was negatively correlated with concurrent imaging (US and CT).
- Black and Hispanic children had lower odds of presenting to hospitals with high concurrent imaging rates compared to White children.
- Patients from lower income quartiles had higher odds of presenting to hospitals with high concurrent imaging rates.
Conclusions:
- Increased ultrasound use is associated with decreased computed tomography utilization in pediatric appendicitis diagnosis.
- Disparities in concurrent imaging rates were observed based on race and socioeconomic status, suggesting potential inequities in care.
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