Implementation of a Contrast Challenge Algorithm for… : Annals of Surgery
variability exists in management of children. Methods: This is a multi-institutional prospective, pre/post-algorithm implementation study of a contrast challenge algorithm in children (≤18 y) admitted with ASBO (10/2021-09/2023). Primary analysis compared patients managed in the pre-implementation phase to those in the post-implementation phase. Secondary analysis compared all patients undergoing CC to those who did not. Primary outcome was LOS. Secondary outcomes included proportion of patients receiving CC, CC-associated complications, and proportion of patients undergoing surgery. Sensitivity, specificity, negative (NPV) and positive (PPV) predictive values of CC were calculated. Results: 264 patients were treated for ASBO (pre-implementation phase: n=77, adoption phase: n=80, post-implementation phase: n=107). CC use increased from 53% to 86% (pre-to-post-implementation; P<0.001). The proportion of patients undergoing surgery (35.1 vs 37.4%, P=0.747) and LOS remained similar (5.1 v
