Abstract
Purpose
We instituted a clinical pathway for the care of patients with perforated appendicitis
based on outcomes from several clinical trials. The objective of this study was to
review effects on resource utilization with this protocol.
Methods
A retrospective review was conducted to compare all patients undergoing appendectomy
during initial admission for perforated appendicitis prior to the pathway (July 2001
to December 2003) to after (December 2008 to March 2011). Demographics and management
strategies were evaluated.
Results
Charts of 151 patients prior to and 259 after the start of the pathway were reviewed.
The percentage of patients leaving the operating room with a nasogastric tube (NGT)
was significantly lower in the after-group, while similar numbers of patients during
each period had a NGT placed on the floor. The proportion of patients receiving peripherally
inserted central catheters and total parenteral nutrition, and the number of intravenous
antibiotics per day and lab draws were significantly reduced with the protocol. Patients
were started on a regular diet significantly earlier, and length of stay was shortened
by more than one day.
Conclusion
The evidence-based clinical pathway developed from prospective trials has drastically
reduced resource utilization for children with perforated appendicitis.
Key words
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Article info
Publication history
Accepted:
March 9,
2013
Received:
February 26,
2013
Footnotes
☆To be presented at the American Academy of Pediatrics Convention 2012.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
