Use of Advanced Radiology During Visits to US Emergency Departments for Injury-Related Conditions, 1998-2007
Use of Advanced Radiology During Visits to US Emergency Departments for Injury-Related Conditions, 1998-2007
复制标题
DOI：
10.1001/jama.2010.1408
复制
发表时间：
2010-10-06
影响因子：
120.7
通讯作者：
Kirsch, Thomas Dean
中科院分区：
文献类型：
--
作者：
Korley, Frederick Kofi;Pham, Julius Cuong;Kirsch, Thomas Dean
过度使用医学成像会增加医疗保健成本和电离辐射暴露目的确定是否有一个变化，在急诊科就诊的患病率与损伤有关的条件，计算机断层扫描（CT）或磁共振成像（MRI），以及危及生命的疾病诊断和患者处置是否发生变化。设计，设置，和参与者使用全国医院门诊医疗调查（1998-2007）的数据对急诊科就诊进行回顾性横断面分析。对抽样就诊进行加权以得出美国的估计值。主要结局指标：在接受CT或MRI检查期间，因损伤相关疾病就诊的比例，（如颈椎骨折、颅骨骨折、颅内出血、肝脏和脾脏撕裂），结果在急诊科因损伤相关疾病就诊时使用CT或MRI的患病率从6%增加到10%，（95%置信区间[CI]，5%-7%）（5237次访视中的257次）至2007年的15%（95% CI，14%-17%）（6567次访视中的981次）（P
Context Excessive use of medical imaging increases health care costs and exposure to ionizing radiation (a potential carcinogen) without yielding significant benefits to all patients.Objective To determine whether there has been a change in the prevalence of emergency department visits for injury-related conditions for which computed tomography (CT) or magnetic resonance imaging (MRI) was obtained and whether there has been a change in the diagnosis of life-threatening conditions and patient disposition.Design, Setting, and Participants Retrospective cross-sectional analysis of emergency department visits using data from the National Hospital Ambulatory Medical Care Survey (1998-2007). Sampled visits were weighted to produce estimates for the United States.Main Outcomes Measures Proportion of visits for injury-related conditions during which a CT or MRI was obtained, a life-threatening condition was diagnosed (eg, cervical spine fracture, skull fracture, intracranial bleeding, liver and spleen laceration), and which resulted in hospital and intensive care unit admission.Results The prevalence of CT or MRI use during emergency department visits for injury-related conditions increased from 6% (95% confidence interval [CI], 5%-7%) (257 of 5237 visits) in 1998 to 15% (95% CI, 14%-17%) (981 of 6567 visits) in 2007 (P