Factors affecting uncertain radiologic reports for pediatric abdominal ultrasound in pediatric emergency departments

Abstract

Abstract Backgrounds Abdominal pain is a common cause for children presenting to pediatric emergency department (PED), which often requires ultrasound (US). However, uncertain reports can lead to additional imaging, which Objective In this study, we evaluated the factors affecting uncertain reports in pediatric abdominal ultrasound in the PED. Materials and Methods This is a retrospective cohort study. Children younger than 18 years at the study hospital between January 2017 and December 2019 who underwent an abdominal US in the PED were eligible. After exclusion, researchers manually reviewed every US report and classified. To identify factors that lead to an uncertain report, univariate and multivariate logistic regression was performed. Results A total of 1006 patients was included in the final analysis. After review, 796 patients were tagged as certain reports, and 210 were tagged as uncertain reports. Children with uncertain reports were more likely to have undergone an additional CT scan (31.0% vs. 2.5%, p <0.001), and had a longer PED length of stay (321 minutes vs. 284.5 minutes, p =0.042). After logistic regression, US performed by a radiology resident (odds ratio [OR] 5.01, 95% confidence interval [CI] 3.63-7.15) was the most significant factor. Conclusion Several factors are responsible for uncertain radiologic reports of abdominal US in the pediatric population. Uncertain radiologic reports increase the likelihood of additional CT scans. Measures to improve the clarity of radiologic reports must be considered to improve the quality of care in children visiting the PED.