%0 Journal Article
%T Accuracy of point-of-care ultrasound in the diagnosis of acute appendicitis in a pediatric emergency department.
%A Balbo S
%A Pini CM
%A Raffaldi I
%A Delmonaco AG
%A Castagno E
%A Guanà R
%A Di Rosa G
%A Bondone C
%J J Clin Ultrasound
%V 52
%N 5
%D 2024 Jun 4
%M 38436504
%F 0.869
%R 10.1002/jcu.23658
%X OBJECTIVE: To investigate the accuracy of point-of-care ultrasound (PoCUS) in diagnosing acute appendicitis in children; to evaluate the concordance between PoCUS performed by a pediatric emergency physician (PedEm) and ultrasonography (US) performed by a radiologist; to draw a "learning curve."
METHODS: We prospectively enrolled children aged 0-14 years old led to the Emergency Department of Regina Margherita Children's Hospital, from January 2021 to June 2021, with suspected acute appendicitis. PoCUS was performed by a single trained PedEm, blindly to the radiologist's scan. A "self-assessment score" and the "time of duration of PoCUS" were recorded for each patient. Final diagnosis of appendicitis was made by a pediatric surgeon.
RESULTS: We enrolled 62 children (2-14 years). Overall sensitivity of PoCUS was 88%, specificity 90%; PPV 90.6%, and NPV 86.6%. Global concordance between the PedEm and the radiologist was good/excellent (k 0.74). The mean duration of PoCUS significantly decreased during the study period, while the self-assessment score increased.
CONCLUSIONS: This is a preliminary study that shows the effectiveness of PoCUS in diagnosing acute appendicitis; furthermore, it shows how the PedEm's performance may improve over time. The learning curve showed how the experience of the PedEm affects the accuracy of PoCUS.