TY - JOUR
T1 - Repeat CT performed within one month of CT conducted in the emergency department for abdominal pain
T2 - A secondary analysis of data from a prospective multicenter study
AU - Lee, Leslie K.
AU - Reisner, Andrew T.
AU - Binder, William D.
AU - Zaheer, Atif
AU - Gunn, Martin L.
AU - Linnau, Ken F.
AU - Miller, Chad M.
AU - Herring, Maurice S.
AU - Tramontano, Angela C.
AU - Kambadakone, Avinash
AU - Catalano, Onofrio A.
AU - Harisinghani, Mukesh
AU - Halpern, Elkan F.
AU - Donelan, Karen
AU - Gazelle, G. Scott
AU - Pandharipande, Pari V.
N1 - Funding Information:
M. L. Gunn receives grant support from Philips Healthcare; G. S. Gazelle is a consultant to GE Healthcare; K. F. Linnau is a paid continuing medical education speaker for Siemens Healthcare and receives publishing royalties from Cambridge Press; A. T. Reisner receives grant support from Nihon Kohden Corporation and is a consultant to Boehringer Ingelheim. P. V. Pandharipande, A. T. Reisner, W. D. Binder, A. Zaheer, M. L. Gunn, K. F. Linnau, C. M. Miller, M. S. Herring, A. C. Tramontano, and K. Donelan received support from the grant from the National Electrical Manufacturers Association during the study.
Funding Information:
Supported by a grant from the National Electrical Manufacturers Association.
Publisher Copyright:
© 2019 American Roentgen Ray Society. All rights reserved.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/2
Y1 - 2019/2
N2 - OBJECTIVE. The purpose of this study is to determine both the frequency of repeat CT performed within 1 month after a patient visits the emergency department (ED) and undergoes CT evaluation for abdominal pain and the frequency of worsened or new CT-based diagnoses. SUBJECTS AND METHODS. Secondary analysis was performed on data collected during a prospective multicenter study. The parent study included patients who underwent CT in the ED for abdominal pain between 2012 and 2014, and these patients constituted the study group of the present analysis. The proportion of patients who underwent (in any setting) repeat abdominal CT within 1 month of the index CT examination was calculated. For each of these patients, results of the index and repeat CT scans were compared by an independent panel and categorized as follows: no change (group 1); same process, improved (group 2); same process, worse (group 3); or different process (group 4). The proportion of patients in groups 1 and 2 versus groups 3 and 4 was calculated, and patient and ED physician characteristics were compared. RESULTS. The parent study included 544 patients (246 of whom were men [45%]; mean patient age, 49.4 years). Of those 544 patients, 53 (10%; 95% CI, 7.5-13%) underwent repeat abdominal CT. Patients' CT comparisons were categorized as follows: group 1 for 43% of patients (23/53), group 2 for 26% (14/53), group 3 for 15% (8/53), and group 4 for 15% (8/53). New or worse findings were present in 30% of patients (16/53) (95% CI, 19-44%). When patients with findings in groups 1 and 2 were compared to patients with findings in groups 3 and 4, no significant difference was noted in patient age (p = 0.25) or sex (p = 0.76), the number of days between scans (p = 0.98), and the diagnostic confidence of the ED physician after the index CT scan was obtained (p = 0.33). CONCLUSION. Short-term, repeat abdominal CT was performed for 10% of patients who underwent CT in the ED for abdominal pain, and it yielded new or worse findings for 30% of those patients.
AB - OBJECTIVE. The purpose of this study is to determine both the frequency of repeat CT performed within 1 month after a patient visits the emergency department (ED) and undergoes CT evaluation for abdominal pain and the frequency of worsened or new CT-based diagnoses. SUBJECTS AND METHODS. Secondary analysis was performed on data collected during a prospective multicenter study. The parent study included patients who underwent CT in the ED for abdominal pain between 2012 and 2014, and these patients constituted the study group of the present analysis. The proportion of patients who underwent (in any setting) repeat abdominal CT within 1 month of the index CT examination was calculated. For each of these patients, results of the index and repeat CT scans were compared by an independent panel and categorized as follows: no change (group 1); same process, improved (group 2); same process, worse (group 3); or different process (group 4). The proportion of patients in groups 1 and 2 versus groups 3 and 4 was calculated, and patient and ED physician characteristics were compared. RESULTS. The parent study included 544 patients (246 of whom were men [45%]; mean patient age, 49.4 years). Of those 544 patients, 53 (10%; 95% CI, 7.5-13%) underwent repeat abdominal CT. Patients' CT comparisons were categorized as follows: group 1 for 43% of patients (23/53), group 2 for 26% (14/53), group 3 for 15% (8/53), and group 4 for 15% (8/53). New or worse findings were present in 30% of patients (16/53) (95% CI, 19-44%). When patients with findings in groups 1 and 2 were compared to patients with findings in groups 3 and 4, no significant difference was noted in patient age (p = 0.25) or sex (p = 0.76), the number of days between scans (p = 0.98), and the diagnostic confidence of the ED physician after the index CT scan was obtained (p = 0.33). CONCLUSION. Short-term, repeat abdominal CT was performed for 10% of patients who underwent CT in the ED for abdominal pain, and it yielded new or worse findings for 30% of those patients.
KW - Abdominal pain
KW - CT
KW - Emergency medicine
KW - Health policy
KW - Resource utilization
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U2 - 10.2214/AJR.18.20060
DO - 10.2214/AJR.18.20060
M3 - Article
C2 - 30512995
AN - SCOPUS:85060201169
VL - 212
SP - 382
EP - 385
JO - The American journal of roentgenology and radium therapy
JF - The American journal of roentgenology and radium therapy
SN - 0361-803X
IS - 2
ER -