Computed tomography use in the adult emergency department of an academic urban hospital from 2001 to 2007

Jarone Lee, Jonathan Kirschner, Sapna Pawa, Dan E. Wiener, David H. Newman, Kaushal Shah

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

Study objective: There is both increasing recognition and growing scrutiny of the increased utilization of computed tomography (CT) in medicine. For our primary objective, we determine and quantify the CT utilization rate in our emergency department (ED) during the last 7 years. As a secondary objective, we compare trends in utilization for various types of CT scans. Methods: We performed an electronic chart review at our inner-city, academic ED with an annual census of 110,000 patients. We identified all patients older than 21 years who had a CT scan performed during ED management from January 2001 to December 2007. Specific, predetermined data elements (eg, subject demographics, type of CT scan) were extracted on standardized data forms by trained abstractors. We analyzed our data with standard descriptive statistics and linear regression. Results: The rate of CT utilization increased steadily at approximately 10 CTs per 1,000 (95% confidence interval 7.5 to 13.6 CTs) patients annually during our study period, from 51 per 1,000 patient visits in 2001 to 106 per 1,000 in 2007. Among these CTs, chest CTs increased most, with a 6-fold increase from 10 per 1,000 patient visits to 60 per 1,000. Neck CTs increased by 5-fold, from 20 per 1,000 patient visits to 100 per 1,000 patients. Similarly, the utilization of abdomen-pelvis CTs, facial bone CTs, and head CTs increased from 13 per 1,000 to 33 per 1,000 patient visits (150%), 1 per 1,000 to 2 per 1,000 patient visits (100%), and 33 per 1,000 to 53 per 1,000 patient visits (60%), respectively. Conclusion: Recent CT utilization in our ED increased in all anatomic categories assessed, with chest CTs and neck CTs increasing the most, followed by abdomen-pelvis CTs, facial bone CTs, and head CTs.

Original languageEnglish (US)
JournalAnnals of Emergency Medicine
Volume56
Issue number6
DOIs
StatePublished - Dec 2010
Externally publishedYes

Fingerprint

Urban Hospitals
Hospital Emergency Service
Tomography
Facial Bones
Pelvis
Abdomen
Neck
Thorax
Head
Censuses
Linear Models
Medicine
Demography
Confidence Intervals

ASJC Scopus subject areas

  • Emergency Medicine

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Computed tomography use in the adult emergency department of an academic urban hospital from 2001 to 2007. / Lee, Jarone; Kirschner, Jonathan; Pawa, Sapna; Wiener, Dan E.; Newman, David H.; Shah, Kaushal.

In: Annals of Emergency Medicine, Vol. 56, No. 6, 12.2010.

Research output: Contribution to journalArticle

Lee, Jarone ; Kirschner, Jonathan ; Pawa, Sapna ; Wiener, Dan E. ; Newman, David H. ; Shah, Kaushal. / Computed tomography use in the adult emergency department of an academic urban hospital from 2001 to 2007. In: Annals of Emergency Medicine. 2010 ; Vol. 56, No. 6.
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abstract = "Study objective: There is both increasing recognition and growing scrutiny of the increased utilization of computed tomography (CT) in medicine. For our primary objective, we determine and quantify the CT utilization rate in our emergency department (ED) during the last 7 years. As a secondary objective, we compare trends in utilization for various types of CT scans. Methods: We performed an electronic chart review at our inner-city, academic ED with an annual census of 110,000 patients. We identified all patients older than 21 years who had a CT scan performed during ED management from January 2001 to December 2007. Specific, predetermined data elements (eg, subject demographics, type of CT scan) were extracted on standardized data forms by trained abstractors. We analyzed our data with standard descriptive statistics and linear regression. Results: The rate of CT utilization increased steadily at approximately 10 CTs per 1,000 (95{\%} confidence interval 7.5 to 13.6 CTs) patients annually during our study period, from 51 per 1,000 patient visits in 2001 to 106 per 1,000 in 2007. Among these CTs, chest CTs increased most, with a 6-fold increase from 10 per 1,000 patient visits to 60 per 1,000. Neck CTs increased by 5-fold, from 20 per 1,000 patient visits to 100 per 1,000 patients. Similarly, the utilization of abdomen-pelvis CTs, facial bone CTs, and head CTs increased from 13 per 1,000 to 33 per 1,000 patient visits (150{\%}), 1 per 1,000 to 2 per 1,000 patient visits (100{\%}), and 33 per 1,000 to 53 per 1,000 patient visits (60{\%}), respectively. Conclusion: Recent CT utilization in our ED increased in all anatomic categories assessed, with chest CTs and neck CTs increasing the most, followed by abdomen-pelvis CTs, facial bone CTs, and head CTs.",
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