Diagnostic Algorithm for Appendicitis Cuts Pediatric CT Use
(HealthDay News) — For pediatric patients, implementation of a diagnostic algorithm for appendicitis correlates with a significant reduction in computed tomography (CT) use without impacting diagnostic accuracy, according to a study published in the August issue of Surgery.
Stephanie F. Polites, MD, from the Mayo Clinic in Rochester, MN, and colleagues examined the impact of a diagnostic algorithm for appendicitis in children, created to reduce CT use. A total of 331 pediatric patients aged ≤18 years who underwent appendectomy for suspected appendicitis were identified for the two years before (41% of patients) and three years after (59% of patients) algorithm implementation. Clinical characteristics and outcomes were compared for the pre- and post-implementation periods.
The researchers found that CT use decreased significantly after algorithm implementation, from 39 to 18% (P<0.001). There was an increase in the negative appendectomy rate from 9 to 11% (P=0.59). CT use did not affect the risk of negative appendectomy (P=0.64).
"Utilization of CT was significantly reduced after implementation of a diagnostic algorithm for appendicitis without impacting diagnostic accuracy," the authors write. "Given the concern for increased risk of cancer after CT, these results support use of an algorithm in children with suspected appendicitis."