The Use of Magnetic Resonance Imaging in the Diagnosis of Suspected Appendicitis in Pregnancy : Shortened Length of Stay Without Increase in Hospital Charges

IMPORTANCE Making an accurate diagnosis of appendicitis in pregnancy is critical for maternal and fetal outcomes. OBJECTIVE To determine whether magnetic resonance (MR) imaging in pregnant patients with suspected appendicitis improves outcomes, minimizes length of stay (LOS), and lowers hospital cha...

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Veröffentlicht in:JAMA surgery 2014-07, Vol.149 (7), p.687-693
Hauptverfasser: Fonseca, Annabelle L, Schuster, Kevin M, Kaplan, Lewis J, Maung, Adrian A, Lui, Felix Y, Davis, Kimberly A
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Sprache:eng
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Zusammenfassung:IMPORTANCE Making an accurate diagnosis of appendicitis in pregnancy is critical for maternal and fetal outcomes. OBJECTIVE To determine whether magnetic resonance (MR) imaging in pregnant patients with suspected appendicitis improves outcomes, minimizes length of stay (LOS), and lowers hospital charges. DESIGN, SETTING, AND PARTICIPANTS Retrospective review at a university tertiary referral center of all pregnant patients seen with abdominal pain and suspected appendicitis who were followed up through delivery during an 11-year period. MAIN OUTCOMES AND MEASURES Time to operation, LOS, complications, nontherapeutic exploration, fetal outcomes, and hospital charges. RESULTS Seventy-nine patients were included in this study, 34 of whom had pathology-confirmed appendicitis. Thirty-one patients underwent MR imaging. A trend toward fewer operations (odds ratio [OR], 0.45; 95% CI, 0.18-1.16; P = .07) was observed in the MR imaging group. Seven nontherapeutic explorations were performed in the non–MR imaging group and 1 nontherapeutic exploration in the MR imaging group (OR, 0.44; 95% CI, 0.08-2.32; P = .13). Patients in the MR imaging group were more frequently discharged from the emergency department (OR, 0.35; 95% CI, 0.13-0.94; P = .04) and had shorter LOS (33.7 vs 64.8 hours, P 
ISSN:2168-6254
2168-6262
DOI:10.1001/jamasurg.2013.4658