Children with symptoms of appendicitis were four times more likely to have a CT scan versus an ultrasound exam if they were admitted to a community hospital rather than a children's hospital, according to a study published online December 24 in Pediatrics.
Researchers at Washington University School of Medicine in St. Louis compared case records of 423 children who had appendectomies, either at St. Louis Children's Hospital (218 patients) or at community hospitals in the area (205 patients) during 2009 and 2010. The researchers analyzed which imaging exams were used and whether surgical results confirmed the diagnosis.
All but 7% of the patients had an imaging exam, according to lead author Dr. Jacqueline Saito, assistant professor of surgery, and colleagues, and 15% had both CT and ultrasound. Approximately 85% of children initially evaluated at community hospitals underwent preoperative CT scans, whereas 45% of children initially seen at St. Louis Children's Hospital had CT scans.
More than half of the patients initially seen at St. Louis Children's Hospital underwent ultrasound to detect appendicitis, compared with 20% of the patients at the community hospitals.
Female patients were 4.5 times more likely to have undergone both CT and ultrasound exams and were associated with a lower ultrasound sensitivity for appendicitis, the authors also reported.
