Evaluation for suspected acute appendicitis in the emergency department setting: a comparison of outcomes among three imaging pathways
Rosenkrantz, Andrew B; Labib, Anthony; Ginocchio, Luke A; Babb, James S
PURPOSE: To compare outcomes of imaging pathways in suspected acute appendicitis. METHODS: Computerized tomography (CT) alone, ultrasound alone, and ultrasound followed by CT were compared in 570 emergency department (ED) patients with suspected acute appendicitis. RESULTS: After initial ultrasound, 9.3% of men and 41.0% of women underwent CT. Body mass index (BMI) (P=.036): 25.3+/-5.7kg/m(2) (CT), 19.1+/-3.3kg/m(2) (ultrasound), and 22.4+/-3.2kg/m(2) (ultrasound then CT). Age (P<.001): 35.9+/-14.5 years (CT), 12.8+/-6.2y (ultrasound), and 21.2+/-9.0 years (ultrasound then CT). ED length-of-stay: 7.0+/-2.8h (CT), 5.9+/-2.8h (ultrasound), and 8.4+/-3.5h (ultrasound then CT). Admission, same-day discharge, appendectomy, pathology positive for appendicitis or complicated appendicitis, 30-day repeat ED visit/hospitalization: no difference between pathways (P=.062-1.00). CONCLUSION: Ultrasound, selected in patients with lowest age/BMI, had shortest length-of-stay but otherwise similar outcomes.
PMID: 27317225
ISSN: 1873-4499
CID: 2145372