Diagnosis and treatment of acute appendicitis in children: a survey among Dutch surgeons and comparison with evidence-based practice

World Journal of Surgery
E C T H TanH van Goor

Abstract

Considerable variability exists in the surgical approach to acute appendicitis in children, affecting both quality and costs of care. A national survey provides insight into daily surgical practice and enables comparison of practice with the available evidence. A national survey was conducted in all 121 Dutch hospitals asking detailed information concerning diagnosis and treatment of children suspected of acute appendicitis. An evidence-based practice (EBP) score was developed on the basis of a critical appraisal of the literature, allowing for classification of reported practices with regard to the level of evidence and identification of hospitals working in accordance with the best available evidence. The overall response rate was 93%. For the diagnosis of acute appendicitis, respondents relied predominantly on patient history (29%) and clinical examination (31%), followed by laboratory results (22%). Only 20% of the departments routinely measured total white blood cell count (WBC), C-reactive protein (CRP) and leukocyte differential count (proportion of polymorphonuclear cells), being part of the triad that provides diagnostic evidence. Although strong evidence exists in favour of routine prophylaxis for suspected appendicit...Continue Reading

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Citations

Feb 22, 2008·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Constantine P SpanosTheodore Syrakos
Nov 12, 2013·International Journal of Surgery·Yasser AlfraihRichard Keijzer
Dec 2, 2008·Journal of Pediatric Surgery·Shawn D St PeterDaniel J Ostlie
Jul 14, 2020·Pediatric Quality & Safety·Yasser AlFraihHelene Flageole
Sep 27, 2018·World Journal of Surgery·Elisabeth M L de WijkersloothBas P L Wijnhoven

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