Effect of clinical practice guideline for children with complicated appendicitis

Editor's Note

This study found that implementation of a clinical practice guideline for management of pediatric complicated appendicitis standardized practice patterns among surgeons and was associated with reduced resource use and improved patient outcomes.

Compared with the pre-guideline group, patients in the post-guideline group were less likely to:

• receive a peripherally inserted central catheter
• require a postoperative CT scan
• have a surgical site infection
• experience any adverse event
• require a second operation.

The post-guideline group also had significantly reduced length of stay.

Most surgeons had very high compliance with the guideline.

Importance Complicated appendicitis is a common condition in children that causes substantial morbidity. Significant variation in practice exists within and between centers. We observed highly variable practices within our hospital and hypothesized that a clinical practice guideline (CPG) would standardize care and be associated with improved patient outcomes.