CT in detecting urinary tract calculi: Influence on patient imaging and clinical outcomes
CT in detecting urinary tract calculi: Influence on patient imaging and clinical outcomes
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DOI：
10.1148/radiol.2252020101
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发表时间：
2002-11-01
期刊：
影响因子：
19.7
通讯作者：
Messing, EM
中科院分区：
文献类型：
--
作者：
Gottlieb, RH;La, TC;Messing, EM
目的：确定自引入平扫螺旋计算机断层扫描 (CT) 对因泌尿道结石 (UTC) 症状而到急诊科 (ED) 就诊的患者进行检查以来，检查模式和护理效果的变化。 材料和方法：使用医院临床和放射学信息系统回顾性识别 1997 年 1 月至 12 月（引入平扫 CT 之前）和 1 月至 12 月出现 UTC 症状的患者1999 年（引入非增强 CT 后）。图表抽象用于确认出现暗示 UTC 症状的患者并评估患者的治疗结果。在引入平扫 CT 之前（1997 年）有 265 名患者就诊，在引入平扫 CT 后（1999 年）有 602 名患者就诊。使用逻辑回归比较 1997 年和 1999 年组之间二分变量的分布。通过方差分析比较各组之间的平均值，并使用泊松回归对影像学研究的平均总数进行比较。结果：每次患者就诊的影像学研究总数增加了 26.7% (P < .001)。初次急诊就诊后的入院率（1997年为13.7%，1999年为13.4%），以及随后返回急诊室的患者百分比（1997年为12.0%，1999年为13.7%）或在初次急诊就诊后的一个月内随后入院（1997年为4.5%，1999年为5.3%），两组之间相似。在 5.9% 的检查中观察到可能影响急性患者护理的意外平扫 CT 结果。 结论：自从引入平扫 CT 以来，对疑似 UTC 的成像使用显着增加，但对急诊室患者的急性护理几乎没有影响。 (C) 北美放射学会，2002 年。
PURPOSE: To determine changes in examination patterns and effectiveness of care since the introduction of unenhanced helical computed tomography (CT) for examination of patients presenting to the emergency department (ED) with symptoms of urinary tract calculi (UTC).MATERIALS AND METHODS: Hospital clinical and radiology information systems were used to retrospectively identify patients presenting with UTC symptoms from January to December 1997 (before introduction of unenhanced CT) and from January to December 1999 (after introduction of unenhanced CT). Chart abstraction was used to confirm the identification of patients with presenting symptoms suggestive of UTC and assess patient outcomes. Two hundred sixty-five patients presented before (1997) and 602 after (1999) unenhanced CT was introduced. Distributions of dichotomous variables were compared between the 1997 and 1999 groups by using logistic regression. Means were compared between the groups by using analysis of variance and mean total numbers of imaging studies by using Poisson regression.RESULTS: Total number of imaging studies increased by 26.7% per patient visit (P < .001). Rates of admission following the initial ED visit (13.7% in 1997 vs 13.4% in 1999), as well as percentage of patients who subsequently returned to the ED (12.0% in 1997 vs 13.7% in 1999) or subsequently were admitted to the hospital (4.5% in 1997 vs 5.3% in 1999) in the month following the initial ED visit, were similar between the two groups. Unsuspected unenhanced CT findings that could affect acute patient care were observed at 5.9% of examinations.CONCLUSION: Use of imaging for suspected UTC has increased markedly since the introduction of unenhanced CT, with little effect on acute care of patients in the ED. (C) RSNA, 2002.