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Reduced use of computed tomography in patients treated with interval appendectomy after implementing a protocol from a prospective, randomized trial

Abstract

Background

In 2009, we instituted a protocol to standardize care for patients undergoing interval appendectomy based on results from a prospective trial that demonstrated a reduction in the mean number of computed tomography (CT) scans performed. The goal of this study was to determine if our current practice now resulted in fewer CT scans as a result of this trial.

Methods

A retrospective review of all patients undergoing interval appendectomy for perforated appendicitis from March 2009 to March 2011 was performed. Demographics and outcomes were compared to previously collected data from a retrospective study prior to institution of the protocol and to the prospective trial.

Results

During the study period, 45 patients underwent interval appendectomy. There were no differences in demographics among the three studies. Similar numbers of patients underwent aspiration or percutaneous drainage. There continues to be a significant reduction in the number of CT scans (3.5 ± 2.0 vs. 2.1 ± 1.3, P = 0.0001) and health care visits (7.6 ± 2.8 vs. 4.5 ± 1.4, P = 0.0001) when comparing management prior to the prospective trial to management since its completion.

Conclusion

A protocol for management of patients undergoing interval appendectomy care results in fewer health care visits and CT scans.

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Correspondence to Shawn D. St. Peter.

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Knott, E.M., Thomas, P., Sharp, N.E. et al. Reduced use of computed tomography in patients treated with interval appendectomy after implementing a protocol from a prospective, randomized trial. Pediatr Surg Int 29, 1293–1296 (2013). https://doi.org/10.1007/s00383-013-3349-x

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Keywords

  • Protocol
  • Clinical pathway
  • Appendicitis
  • Children
  • Resource utilization
  • Computed topography