Background: Tomography is the most accurate method for diagnosis of acute appendicitis, however, ther are clinical prediction rules that combine symptoms, physical examination and paraclinics to optimize its use. Our objective was to compare the frequency of tomography before and after the implementation of the appendicitis guide in the emergency room of a fourth level hospital in the city of Bogotá. Methods: Observational, analytical, historical cohort study, comparing 2 independent groups. Includes adults with abdominal pain and suspected acute appendicitis. We used simple random probability sampling, we compared the percentage of requested CT scans and the time elapsed between admission and the definition of the destination, and we calculated the proportion of readmissions. Results: There were no significant differences with respect to gender. Right iliac fossa pain was the most frequent finding, leukocytosis was only observed in 38.5% of the patients. Tomography was performed in two thirds of all patients, with no significant difference before or after the implementation of the guideline. The median length of stay in the emergency room was 4 hours shorter in the after group. The rate of readmissions did not exceed 1%. Conclusion: The implementation of the acute appendicitis guide did not significantly change the use of tomography in the study of these patients, however, it did significantly reduce the length of stay in the emergency room.
publication date
March 11, 2021 5:16 PM
Research
keywords
Care protocols in emergency medical services
Clinical decision rules in the primary diagnosis of Appendicitis
Use of diagnostic guidelines for appendicitis
X-ray Computed Tomography in the diagnosis of acute appendicitis
