Radiology imaging delays as independent predictors of length of hospital stay for emergency medical admissions
Radiology imaging delays as independent predictors of length of hospital stay for emergency medical admissions
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DOI：
10.1016/j.crad.2016.03.023
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发表时间：
2016-09-01
影响因子：
2.6
通讯作者：
Silke, B.
中科院分区：
文献类型：
--
作者：
Cournane, S.;Conway, R.;Silke, B.
目的：研究计算机断层扫描(CT)、磁共振成像(MRI)和超声检查的完成时间在多大程度上影响住院时间和住院费用，同时考虑患者的敏感度。材料和方法：评估2010-2014年间所有急诊入院，总计25326次影像检查。每种成像类型的第50、7和90百分位数的完成时间被输入预测住院时间的多变量截断泊松回归模型。根据急性疾病严重程度、Charlson共病指数、慢性致残性疾病评分和脓毒症状态对回归因素的风险估计(优势比或发病率比[IRR])进行调整。结果：在所有的影像检查中，住院时间的延长与影像时间的延迟有关。CT和MRI延迟的增加被证明与医院发作成本的增加有关，而超声波并不独立地预测医院成本的增加。结论：CT、MRI和超声在不同临床复杂性的患者中进行了检查；然而，即使对复杂性进行了调整，更快速的放射服务的时间延迟也可能缩短住院时间并降低成本。(C)2016年皇家放射科医生学会。爱思唯尔有限公司出版。保留所有权利。
AIM: To investigate the extent to which the time to completion for computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound could be shown to influence the length of stay and costs incurred while in hospital, while accounting for patient acuity.MATERIALS AND METHODS: All emergency admissions, totalling 25,326 imaging investigations between 2010-2014 were evaluated. The 50th 7-th, and 90th centiles of completion times for each imaging type was entered into a multivariable truncated Poisson regression model predicting the length of hospital stay. Estimates of risk (odds or incidence rate ratios [IRRs]) of the regressors were adjusted for acute illness severity, Charlson comorbidity index, chronic disabling disease score, and sepsis status. Quantile regression analysis was used to examine the impact of imaging on total hospital costs.RESULTS: For all imaging examinations, longer hospital lengths of stay were shown to be related to delays in imaging time. Increased delays in CT and MRI were shown to be associated with increased hospital episode costs, while ultrasound did not independently predict increased hospital costs. The magnitude of the effect of imaging delays on episode costs were equivalent to some measures of illness severity.CONCLUSION: CT, MRI, and ultrasound are undertaken in patients with differing clinical complexity; however, even with adjustment for complexity, the time delay in a more expeditious radiological service could potentially shorten the hospital episode and reduce costs. (C) 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.