Increasing utilization of abdominal CT in the Emergency Department of a secondary care center: does it produce better outcomes in caring for pediatric surgical patients?
Increasing utilization of abdominal CT in the Emergency Department of a secondary care center: does it produce better outcomes in caring for pediatric surgical patients?
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DOI：
10.4174/astr.2014.87.5.239
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发表时间：
2014-11
影响因子：
1.4
通讯作者：
Moon SB
中科院分区：
文献类型：
--
作者：
Kim Y;Kang G;Moon SB
在儿科急诊科（艾德），腹部计算机断层扫描（ACT）的使用正在显著增加，但增加ACT在儿科手术患者中的临床获益仍不确定。进行了一项回顾性审查，以调查在过去5年中访问过儿科艾德的患者，增加ACT的使用是否会增加急性阑尾炎的检出率，增加阑尾炎以外的手术条件的检出率，并降低手术条件的住院率。在研究期间，有37，918例艾德访视;其中，3，274例（8.6%）因腹痛，844例（2.2%）进行了ACT。ACT的年比例增加具有统计学意义（1.56%至2.46%，P = 0.00），但急性阑尾炎（3.3%至5.1%）或其他手术条件（1.7%至2.8%）的检出率无统计学意义的变化。住院率（5.6%至6.8%）在研究期间也没有显着变化。增加ACT的使用并不能改善儿科急诊的儿科手术患者的护理结果。儿科急诊需要对ACT的适应症进行仔细评估。
The use of abdominal computed tomography (ACT) utilization is increasing to a remarkable extent in the pediatric Emergency Department (ED), but the clinical benefit of increased use of ACT for pediatric surgical patients remains uncertain. A retrospective review was conducted to investigate if, for patients who had visited pediatric ED during the last 5 years, increasing utilization of ACT would increase the detection rate of acute appendicitis, increase the detection rate of surgical conditions other than appendicitis, and decrease the hospital admission rate for surgical conditions. During the study period, there were 37,918 ED visits; of these, 3,274 (8.6%) were for abdominal pain, 844 (2.2%) had ACT performed. The annual proportional increase of the ACT was statistically significant (1.56% to 2.46%, P = 0.00), but the detection rate of acute appendicitis (3.3% to 5.1%) or other surgical conditions (1.7% to 2.8%) showed no statistically significant changes. Hospital admission rates (5.6% to 6.8%) also showed no significant changes during the study period. Increasing utilization of ACT does not lead to the improved outcomes in caring for pediatric surgical patients visiting the pediatric ED. Careful evaluation for the indication for ACT is needed in the pediatric ED.
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