Trends in Computed Tomography Utilization and Association with Hospital Outcomes in a Chinese Emergency Department
Open Access
- 12 July 2012
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 7 (7), e40403
- https://doi.org/10.1371/journal.pone.0040403
Abstract
Excessive use of computed tomography (CT) in emergency departments (EDs) has become a concern due to its expense and the potential risks associated with radiation exposure. Although studies have shown a steady increase in the number of CT scans requested by ED physicians in developed countries like the United States and Australia, few empirical data are available regarding China. We retrospectively analyzed a database of ED visits to a tertiary Chinese hospital to examine trends in CT utilization and their association with ED outcomes between 2005 and 2008. A total of 197,512 ED visits were included in this study. CT utilization increased from 9.8% in 2005 to 13.9% in 2008 (P<.001 for trend). The ED length of stay for visits with CT utilization was 0.6 hour longer than those in which CT was not obtained. CT utilization increased the ED cost by an average $48.2. After adjustment for patients’ demographics, arrival hours and clinical condition, CT utilization during ED visits was significantly associated with high ED cost (Odds Ratio [OR]: 21.70; 95% confidence interval [CI], 17.00–27.71), long ED length of stay (OR: 1.22; 95%CI, 1.12–1.34), and more likely to receive emergency operations (OR: 2.31; 95%CI, 1.94–2.76). However, there was no significant correlation between CT use and the possibility to be admitted to inpatient wards (OR: 0.82; 95%CI, 0.65–1.04). With respect to the time-related trends, CT utilization during ED visits in all study years was significantly associated with high ED cost and more likely to receive emergency operations. CT utilization was associated with higher ED cost, longer ED length of stay and more likely to receive emergency operations, but did not correlate with a significant change in the admission rate.Keywords
This publication has 20 references indexed in Scilit:
- High Hospital Occupancy Is Associated with Increased Risk for Patients Boarding in the Emergency DepartmentAmerican Journal Of Medicine, 2012
- Computed Tomography Scan Utilization in Emergency Departments: A Multi-State AnalysisThe Journal of Emergency Medicine, 2011
- Use of Advanced Radiology During Visits to US Emergency Departments for Injury-Related Conditions, 1998-2007JAMA, 2010
- Radiation exposure and the justification of computed tomography scanning in an Australian hospital emergency departmentInternal Medicine Journal, 2009
- Trends in the Rates of Radiography Use and Important Diagnoses in Emergency Department Patients With Abdominal PainMedical Care, 2009
- Computed Tomography — An Increasing Source of Radiation ExposureNew England Journal of Medicine, 2007
- Whole Body Imaging in Blunt Multisystem Trauma Patients Without Obvious Signs of InjuryArchives of Surgery, 2006
- Reliability and Validity of Scores on the Emergency Severity Index Version 3Academic Emergency Medicine, 2004
- Doctors' knowledge of radiation exposure: questionnaire studyBMJ, 2003
- Indications for Computed Tomography in Patients with Minor Head InjuryNew England Journal of Medicine, 2000