title: The impact of early sonographic evaluation on hospital admissions of children with suspected acute appendicitis.
abstract: OBJECTIVE
  Early ultrasound (US) evaluation of children with abdominal pain and suspected acute appendicitis (AA) is an important diagnostic tool. Since 2007, US has become part of routine emergency room (ER) work-up performed for suspected pediatric AA in our hospital.
  
  
  METHODS
  We retrospectively compared hospital admissions from 2007 to 2008 with those from 2005 to 2006, when most ultrasounds were done after admission to Pediatric Surgery for observation.
  
  
  RESULTS
  During the study (2005-2008), 6,511 children came to the ER with acute abdominal pain. Although pediatric ER sonography increased from 28.1% (865/3,079) in 2005-2006 to 51.7% (1,775/3,432) in 2007-2008 (p < 0.0001), hospitalizations decreased from 33 to 30.1% (p = 0.011). Concurrently, ER US for AA increased from 20.8% (639/2,440) to 38.9% (1,336/2,096) (p < 0.0001), admissions for suspected AA decreased from 51.8% (331/639) to 42% (561/1,336) (p < 0.0001).
  
  
  CONCLUSIONS
  Sonography led to a significant decline in admissions and better selection of patients who required surgery for AA. Recurrent ER referrals for the same complaint within 2 weeks was very low (2.9%) with no difference between the two study periods (p = 1); none had AA. These findings encourage us to continue early US in children with suspected AA. This effective tool decreases unnecessary hospital stays, investigative procedures, and surgery, while reducing costs.
authors.affiliation: Department of Urology, Meir Medical Center (Affiliated with the Sackler School of Medicine, Tel Aviv University), Kfar Saba, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Vainrib
authors.forename: Genady
authors.initials: G
authors.lastname: Buklan
authors.forename: Michael
authors.initials: M
authors.lastname: Gutermacher
authors.forename: Ludwig
authors.initials: L
authors.lastname: Lazar
authors.forename: Myriam
authors.initials: M
authors.lastname: Werner
authors.forename: Valeria
authors.initials: V
authors.lastname: Rathaus
authors.forename: Ilan
authors.initials: I
authors.lastname: Erez
mesh_terms: D000293:Adolescent; D001064:Appendicitis / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D014463:Ultrasonography