National Trends in CT Use in the Emergency Department: 1995-2007
National Trends in CT Use in the Emergency Department: 1995-2007
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DOI：
10.1148/radiol.10100640
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发表时间：
2011-01-01
期刊：
影响因子：
19.7
通讯作者：
Forman, Howard P.
中科院分区：
文献类型：
--
作者：
Larson, David B.;Johnson, Lara W.;Forman, Howard P.
目的：确定与急诊科 (ED) 使用计算机断层扫描 (CT) 相关的全国趋势和因素。材料和方法：本研究免于机构审查委员会批准。 1995-2007 年全国医院门诊医疗调查的数据用于评估与 CT 相关的急诊就诊次数和百分比。每年平均对 30 044 次访问进行抽样调查。数据还根据多个患者和医院的特征进行了细分。进行 Rao-Scott chi(2) 检验以确定 CT 使用在不同亚群中是否相似。根据指数和逻辑增长模型对数据进行评估。结果：从1995年到2007年，包括CT检查在内的急诊就诊人数从270万人次增加到1620万人次，增长了5.9倍，年复合增长率为16.0%。 CT相关就诊比例从2.8%上升至13.9%，增长了4.9倍，复合年增长率为14.2%。指数增长模型最适合 CT 使用趋势。 CT 在老年患者、白人患者、住院患者以及大都市地区医疗机构的患者中使用较多。到研究期结束时，接受 CT 治疗的患者最常抱怨的是腹痛、头痛和胸痛。所有经评估的主诉中与 CT 相关的患者就诊比例均有所增加，其中因胁腹痛、腹部疼痛或胸痛而接受 CT 治疗的患者比例增加最为显着。结论：与其他环境相比，急诊室中 CT 使用率的增加更高。到 2007 年，CT 的总体使用尚未开始减少。(C) RSNA，2010
Purpose: To identify nationwide trends and factors associated with the use of computed tomography (CT) in the emergency department (ED).Materials and Methods: This study was exempt from institutional review board approval. Data from the 1995-2007 National Hospital Ambulatory Medical Care Survey were used to evaluate the numbers and percentages of ED visits associated with CT. A mean of 30 044 visits were sampled each year. Data were also subcategorized according to multiple patient and hospital characteristics. The Rao-Scott chi(2) test was performed to determine whether CT use was similar across subpopulations. Data were evaluated according to exponential and logistic growth models.Results: From 1995 to 2007, the number of ED visits that included a CT examination increased from 2.7 million to 16.2 million, constituting a 5.9-fold increase and a compound annual growth rate of 16.0%. The percentage of visits associated with CT increased from 2.8% to 13.9%, constituting a 4.9-fold increase and a compound annual growth rate of 14.2%. The exponential growth model provided the best fit for the trend in CT use. CT use was greater in older patients, white patients, patients admitted to the hospital, and patients at facilities in metropolitan regions. By the end of the study period, the top chief complaints among those who underwent CT were abdominal pain, headache, and chest pain. The percentage of patient visits associated with CT for all evaluated chief complaints increased-most substantially among those who underwent CT for flank, abdominal, or chest pain.Conclusion: Use of CT has increased at a higher rate in the ED than in other settings. The overall use of CT had not begun to taper by 2007. (C) RSNA, 2010