Utilization of chest CT for injured patients during visits to U.S. emergency departments : 2012-2015
Copyright © 2018 Elsevier Inc. All rights reserved..
INTRODUCTION: Increased use of computed tomography (CT) during injury-related Emergency Department (ED) visits has been reported, despite increased awareness of CT radiation exposure risks. We investigated national trends in the use of chest CT during injury-related ED visits between 2012 and 2015.
METHODS: Analyzing injury-related ED visits from the 2012-2015 United States (U.S.) National Hospital Ambulatory Medical Care Survey (NHAMCS), we determined the percentage of visits that had a chest CT and the diagnostic yield of these chest CTs for clinically-significant findings. We used survey-weighted multivariable logistic regression to determine which patient and visit characteristics were associated with chest CT use.
RESULTS: Injury-related visits accounted for 30% of the 135 million yearly ED visits represented in NHAMCS. Of these visits, 817,480 (2%) received a chest CT over the study period. The diagnostic yield was 3.88%. Chest CT utilization did not change significantly from a rate of 1.73% in 2012 to a rate of 2.31% in 2015 (p = 0.14). Multivariate logistic regression demonstrated increased odds of chest CT for patients seen by residents versus by attendings (adjusted odds ratio [AOR] 2.08, 95% confidence interval [CI] 1.41-3.08). Patients aged 18-59 and 60+ had higher AORs (5.75, CI 3.44-9.61 and 9.81, CI 5.90-16.33, respectively) than those <18 years of receiving chest CT.
CONCLUSIONS: Overall chest CT utilization showed an increased trend from 2012 to 2015, but the results were not statistically significant.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
The American journal of emergency medicine - 37(2019), 5 vom: 06. Mai, Seite 909-912 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Yun, Brian J [VerfasserIn] |
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| Links: |
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| Themen: |
Chest CT |
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| Anmerkungen: |
Date Completed 24.12.2019 Date Revised 24.12.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ajem.2018.08.024 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM287393356 |
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| 100 | 1 | |a Yun, Brian J |e verfasserin |4 aut | |
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| 500 | |a Date Completed 24.12.2019 | ||
| 500 | |a Date Revised 24.12.2019 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2018 Elsevier Inc. All rights reserved. | ||
| 520 | |a INTRODUCTION: Increased use of computed tomography (CT) during injury-related Emergency Department (ED) visits has been reported, despite increased awareness of CT radiation exposure risks. We investigated national trends in the use of chest CT during injury-related ED visits between 2012 and 2015 | ||
| 520 | |a METHODS: Analyzing injury-related ED visits from the 2012-2015 United States (U.S.) National Hospital Ambulatory Medical Care Survey (NHAMCS), we determined the percentage of visits that had a chest CT and the diagnostic yield of these chest CTs for clinically-significant findings. We used survey-weighted multivariable logistic regression to determine which patient and visit characteristics were associated with chest CT use | ||
| 520 | |a RESULTS: Injury-related visits accounted for 30% of the 135 million yearly ED visits represented in NHAMCS. Of these visits, 817,480 (2%) received a chest CT over the study period. The diagnostic yield was 3.88%. Chest CT utilization did not change significantly from a rate of 1.73% in 2012 to a rate of 2.31% in 2015 (p = 0.14). Multivariate logistic regression demonstrated increased odds of chest CT for patients seen by residents versus by attendings (adjusted odds ratio [AOR] 2.08, 95% confidence interval [CI] 1.41-3.08). Patients aged 18-59 and 60+ had higher AORs (5.75, CI 3.44-9.61 and 9.81, CI 5.90-16.33, respectively) than those <18 years of receiving chest CT | ||
| 520 | |a CONCLUSIONS: Overall chest CT utilization showed an increased trend from 2012 to 2015, but the results were not statistically significant | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Chest CT | |
| 650 | 4 | |a Diagnostic Imaging | |
| 650 | 4 | |a Thoracic Injuries | |
| 650 | 4 | |a Trauma | |
| 700 | 1 | |a Rodriguez, Robert M |e verfasserin |4 aut | |
| 700 | 1 | |a Prabhakar, Anand M |e verfasserin |4 aut | |
| 700 | 1 | |a Peak, David A |e verfasserin |4 aut | |
| 700 | 1 | |a Baymon, DaMarcus E |e verfasserin |4 aut | |
| 700 | 1 | |a Raja, Ali S |e verfasserin |4 aut | |
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