Hryhorczuk 2012


Year: 2012

Title: Pediatric abdominal pain: use of imaging in the emergency department in the United States from 1999 to 2007

Country: United States

Age: Pediatric Only

Sex: All Sexes

Population: Multiple Groups

Care Setting: Emergency Department

Clinical Setting: GI/Abdominal

Data Level: National

Data Type: Government Survey

Data Source: National Hospital Ambulatory Medical Care Survey

Conclusion: Disparities In All Minority Groups

Health OutComes Reported: No

Mitigation: No

Free Text Conclusion: Non-white patients less likely to get CT or US for non-traumatic abdominal pain.

Abstract: Purpose: To evaluate use of imaging in children with acute abdominal pain who present to U.S. emergency departments (EDs). Materials and methods: This study received expedited review by the institutional review board. The National Hospital Ambulatory Medical Care Survey is a government-administered yearly survey of EDs that is used to estimate ED care throughout the United States. This retrospective cohort study interrogated the database for the period from 1999 to 2007. Univariate regression analysis was performed, and a multivariate regression model was developed. Results: From 1999 to 2007, 16 900 000 pediatric ED visits were made for acute abdominal pain. Odds of undergoing computed tomography (CT) in this population increased during each year of the study period. No significant changes occurred in use of ultrasonography, number of patients admitted to the hospital, or number of patients with acute appendicitis. A multivariate model for CT use revealed increased odds of CT use in teens, white patients, the Midwest region, urban settings, patients with private insurance, and patients who were admitted or transferred. Odds of undergoing CT were significantly lower among patients who presented to a pediatric-focused emergency department (adjusted odds ratio, 0.72; 95% confidence interval: 0.58, 0.90). Conclusion: The main findings of this study are that the rate of CT use in the evaluation of abdominal pain in children increased every year between 1999 and 2007 and that the use of CT was greater among children seen in adult-focused EDs. Factors affecting CT use include sex, race, age, insurance status, and geographic region.