对CT利用评估算法的影响,用于识别儿童尾炎
Kendra L Sikes1, Rebecca J Hart2, Yana Feygin1
1From the Interdisciplinary Research Group.
Pediatric emergency care
|February 17, 2024
概括
尾炎评估算法没有显著改变儿科患者的计算机断层扫描 (CT) 使用或停留时间 (LOS). 然而,该算法与急诊室 (ED) 停留时间的显著增加有关.
科学领域:
- 儿科急救医学 儿科急救医学
- 诊断成像 诊断成像 诊断成像
- 临床算法实施方案
背景情况:
- 急性尾炎是儿童常见的手术紧急情况.
- 计算机断层扫描 (CT) 和超声波经常用于诊断,影响患者护理和资源利用.
- 标准化的评估算法旨在优化诊断途径.
研究的目的:
- 评估尾炎评估算法对儿科患者CT利用率和停留时间 (LOS) 的影响.
- 为了确定算法是否导致诊断成像率和患者处置时间的显著变化.
主要方法:
- 对儿童患者 (3-18岁) 的回顾性图表审查,评估尾炎.
- 数据收集了算法实施前和后6个月的数据,有3个月的洗期.
- 分析CT和超声波利用率,以及使用统计测试的急诊室 (ED) LOS (chi-squared,Mann-Whitney U).
主要成果:
- 在CT利用率 (25.7%至24.8%) 或超声波利用率 (59.5%至59.7%) 中没有显著变化.
- 总ED中位数LOS的显著增加被观察到 (333.50到362.00分钟;P = 0.011).
- 与CT使用相关的因素包括发烧,疼痛迁移和右下象限疼痛.
结论:
- 实施的尾炎评估算法没有显著减少CT利用率或LOS.
- 高比例的模两可的超声检测结果可能会导致CT持续使用和LOS增加.
- 需要进一步完善诊断策略,以优化对儿科尾炎评估的护理.
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