Volume 6 Supplement 1
The effect of point-of- care ultrasonography on emergency department length of stay and CT utilization in children with suspected appendicitis
© Tsung et al; licensee Springer. 2014
Published: 31 January 2014
The role of clinician-performed ultrasonography for suspected appendicitis is controversial. Published data conclude that ultrasonography has high specificity to rule in the diagnosis of appendicitis with variable sensitivity to rule it out. Newer data suggest that point-of-care ultrasonography (PoCUS) may have similar test characteristics. This is the first study to examine the effect of point-of-care ultrasonography on emergency department (ED) length of stay (LOS) and CT utilization in children with suspected appendicitis.
To evaluate the sensitivity, specificity, positive and negative likelihood ratios of PoCUS for children with suspected appendicitis and its effect on ED LOS and CT utilization.
The study involved a prospective observational convenience sample of children with suspected appendicitis requiring imaging evaluation adhering to the STARD criteria to determine PoCUS test characteristics. Outcomes were determined by operative or pathology report in those that had appendicitis, and three week phone follow-up in those patients that were non operative. Differences in ED LOS were analyzed by ANOVA between patients who received a disposition after PoCUS, radiology US (RUS), or CT.
Test Performance Characteristics
Sensitivity % (95% CI)
Specificity % (95% CI)
45 (2.86 – 707.68)
PoCUS by clinicians reduced ED LOS and CT utilization in subsets of children with suspected appendicitis. This practice appears to be highly specific and safe when used to rule in appendicitis.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.