Utilization of chest CT for injured patients during visits to U.S. emergency departments: 2012-2015.

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  • Additional Information
    • Source:
      Publisher: W B Saunders Country of Publication: United States NLM ID: 8309942 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8171 (Electronic) Linking ISSN: 07356757 NLM ISO Abbreviation: Am J Emerg Med Subsets: MEDLINE
    • Publication Information:
      Publication: 1983- : Philadelphia, PA : W B Saunders
      Original Publication: [Philadelphia, PA. : Centrum Philadelphia, c1983]-
    • Subject Terms:
      Emergency Service, Hospital/*statistics & numerical data ; Thorax/*diagnostic imaging ; Tomography, X-Ray Computed/*statistics & numerical data; Adolescent ; Adult ; Health Care Surveys ; Humans ; Logistic Models ; Middle Aged ; Tomography, X-Ray Computed/adverse effects ; United States/epidemiology ; Wounds and Injuries/diagnostic imaging ; Wounds and Injuries/epidemiology
    • Abstract:
      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.
      (Copyright © 2018 Elsevier Inc. All rights reserved.)
    • Contributed Indexing:
      Keywords: Chest CT; Diagnostic Imaging; Thoracic Injuries; Trauma
    • Publication Date:
      Date Created: 20180814 Date Completed: 20191224 Latest Revision: 20191224
    • Publication Date:
      20221213
    • Accession Number:
      10.1016/j.ajem.2018.08.024
    • Accession Number:
      30100335