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Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period

During the COVID-19 pandemic, the number of accesses to the Pediatric Emergency Department (pED) in Italy sharply decreased by 30%. The purpose of this study is to evaluate how this novel setting impacted on management of children with trauma, and the use and appropriateness of imaging studies in su...

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Autores principales: Bottari, Giampiero, Stellacci, Giandomenico, Ferorelli, Davide, Dell’Erba, Alessandro, Aricò, Maurizio, Benevento, Marcello, Palladino, Giuseppe, Solarino, Biagio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227712/
https://www.ncbi.nlm.nih.gov/pubmed/34205841
http://dx.doi.org/10.3390/children8060463
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author Bottari, Giampiero
Stellacci, Giandomenico
Ferorelli, Davide
Dell’Erba, Alessandro
Aricò, Maurizio
Benevento, Marcello
Palladino, Giuseppe
Solarino, Biagio
author_facet Bottari, Giampiero
Stellacci, Giandomenico
Ferorelli, Davide
Dell’Erba, Alessandro
Aricò, Maurizio
Benevento, Marcello
Palladino, Giuseppe
Solarino, Biagio
author_sort Bottari, Giampiero
collection PubMed
description During the COVID-19 pandemic, the number of accesses to the Pediatric Emergency Department (pED) in Italy sharply decreased by 30%. The purpose of this study is to evaluate how this novel setting impacted on management of children with trauma, and the use and appropriateness of imaging studies in such patients at the pED. All imaging studies performed in patients with trauma at the pED of a tertiary children’s Hospital during the first wave of the COVID-19 pandemic (between March and May 2020) were reviewed, in comparison with a control time interval (March to May 2019). In the pre-COVID control era, 669 imaging studies documented bone fractures in 145/568 children (25.5%). In the COVID-era, 79/177 (44.6%) pediatric patients showed bone fractures on 193 imaging studies. Comparative analysis shows a 71% decrease in imaging studies, and the proportion of negative imaging studies (with no evidence of bone fractures) dropped in 2020 by 19% compared to the 2019 control era (p < 0.001). The sharp decrease of negative studies suggests that the rate of appropriateness was higher during COVID-era, suggesting some attitude toward defensive medicine in the previous control year, as a result of some degree of imaging inappropriateness. The impact of a pandemic on emergency medicine may offer a unique opportunity to revisit diagnostic and therapeutic protocols in pediatrics.
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spelling pubmed-82277122021-06-26 Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period Bottari, Giampiero Stellacci, Giandomenico Ferorelli, Davide Dell’Erba, Alessandro Aricò, Maurizio Benevento, Marcello Palladino, Giuseppe Solarino, Biagio Children (Basel) Brief Report During the COVID-19 pandemic, the number of accesses to the Pediatric Emergency Department (pED) in Italy sharply decreased by 30%. The purpose of this study is to evaluate how this novel setting impacted on management of children with trauma, and the use and appropriateness of imaging studies in such patients at the pED. All imaging studies performed in patients with trauma at the pED of a tertiary children’s Hospital during the first wave of the COVID-19 pandemic (between March and May 2020) were reviewed, in comparison with a control time interval (March to May 2019). In the pre-COVID control era, 669 imaging studies documented bone fractures in 145/568 children (25.5%). In the COVID-era, 79/177 (44.6%) pediatric patients showed bone fractures on 193 imaging studies. Comparative analysis shows a 71% decrease in imaging studies, and the proportion of negative imaging studies (with no evidence of bone fractures) dropped in 2020 by 19% compared to the 2019 control era (p < 0.001). The sharp decrease of negative studies suggests that the rate of appropriateness was higher during COVID-era, suggesting some attitude toward defensive medicine in the previous control year, as a result of some degree of imaging inappropriateness. The impact of a pandemic on emergency medicine may offer a unique opportunity to revisit diagnostic and therapeutic protocols in pediatrics. MDPI 2021-06-01 /pmc/articles/PMC8227712/ /pubmed/34205841 http://dx.doi.org/10.3390/children8060463 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Bottari, Giampiero
Stellacci, Giandomenico
Ferorelli, Davide
Dell’Erba, Alessandro
Aricò, Maurizio
Benevento, Marcello
Palladino, Giuseppe
Solarino, Biagio
Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period
title Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period
title_full Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period
title_fullStr Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period
title_full_unstemmed Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period
title_short Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period
title_sort imaging appropriateness in pediatric radiology during covid-19 pandemic: a retrospective comparison with no covid-19 period
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227712/
https://www.ncbi.nlm.nih.gov/pubmed/34205841
http://dx.doi.org/10.3390/children8060463
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