Pediatric Acute Mastoiditis: Which Factors Influence CT Scan Prescription and Surgical Intervention? A Multivariate Analysis

BACKGROUND: The aim of this study is to investigate factors associated with computed tomography (CT) scan prescription and surgical intervention in pediatric patients with acute mastoiditis (AM). METHODS: Children with AM admitted to Modena University Hospital over a 10-year period were retrospectively divided into 3 groups: those who did not undergo a CT scan nor surgery (Group A); those who underwent a CT scan but not surgery (Group B); and those who underwent CT scan and surgery (Group C). A multivariate analysis was performed to determine possible differences among groups in terms of clinical and laboratory variables. RESULTS: In total, 80 patients were included (57 Group A, 22 Group B, 13 Group C). Factors independently associated with CT scan prescription and surgical intervention were WBC count (P = .015 and .041, respectively), CRP (P = .001 and .003, respectively), and at-home antibiotic administration (P = .008 and .039, respectively). CONCLUSION: Laboratory parameters may be helpful in guiding pediatric AM management. Antibiotic treatment prior to admission is associated with a worse clinical picture.