Emergency departments see substantial increase in CT exams

November 29, 2010

OAK BROOK, Ill. - A new study reports that the use of computed tomography (CT) in the nation's emergency departments is growing exponentially. If the growth trend continues, by 2011, nearly 20 percent of all emergency department (ED) visits may involve a CT exam. The results of this study were presented today at the annual meeting of the Radiological Society of North America (RSNA) and published online and in the journal Radiology.

"It is not surprising that CT utilization has increased," said lead researcher David B. Larson, M.D., M.B.A., director of quality improvement in the department of radiology at Cincinnati Children's Hospital Medical Center in Ohio. "What's surprising is the sustained high rate of that growth. However, recent developments, such as increased awareness of cost, radiation concerns, national health care reform legislation and the economic recession, are likely to inhibit further growth."

Dr. Larson's research team used data collected by the National Hospital Ambulatory Medical Care Survey from 1995 through 2007 to identify nationwide trends associated with CT use in the ED. The researchers performed statistical analysis on a mean of 30,044 ED visits from each year over the 13-year period to estimate overall usage of CT in the ED.

"We have seen a remarkable growth in CT utilization, not only in the number of ED visits that involve CT imaging but in the percentage of patients walking into the ED that receive a CT," Dr. Larson said.

According to the analysis, the number of ED visits that included a CT exam increased from 2.7 million in 1995 to 16.2 million in 2007, a 5.9-fold increase and an average growth rate of 16 percent per year. The percentage of ED visits involving a CT exam rose from 2.8 percent in 1995 to 13.9 percent in 2007.

"CT is a wonderful technique that is widely available," Dr. Larson said. "Over the 13 years in our study, image resolution improved significantly, making CT a great tool to look for kidney stones, appendicitis and coronary artery disease."

For much of the 13-year period studied, headache was the complaint most commonly associated with a CT exam in the ED. But by 2007, headache was surpassed by abdominal pain as the complaint most often associated with CT imaging. In 2007, patients with abdominal pain represented 12.8 percent of all ED visits involving CT.

CT exams to investigate abdominal pain have a higher radiation dose than CT exams used to determine the cause of a headache. The study found that, overall, the use of CT for complaints that are typically related to exams with a higher radiation dose grew faster than those typically related to exams with a lower radiation dose. This suggests that the radiation dose associated with CT in the ED may be growing at a faster rate than the growth in the overall use of CT.

In 1995, a patient visiting the ED with chest pain rarely received a CT exam. But by 2007, chest pain was the third most common complaint in the ED associated with CT imaging.

"Our emphasis now should be on carefully evaluating the use of CT in specific situations and making sure it is used appropriately," Dr. Larson said.
-end-
"National Trends in CT Use in the Emergency Department: 1995-2007." Collaborating with Dr. Larson were Lara W. Johnson, M.D., Beverly M. Schnell, Ph.D., Sheila R. Salisbury, Ph.D., and Howard P. Forman, M.D., M.B.A.

Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc. (http://radiology.rsna.org/)

RSNA is an association of more than 46,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. The Society is based in Oak Brook, Ill. (RSNA.org)

For patient-friendly information on CT and radiation safety, visit RadiologyInfo.org.

Radiological Society of North America

Related Emergency Department Articles from Brightsurf:

Deep learning in the emergency department
Harnessing the power of deep learning leads to better predictions of patient admissions and flow in emergency departments

Checklist for emergency department team's COVID-19 surge
After reviewing the literature on COVID-19 scientific publications the authors developed a checklist to guide emergency departments.

Why is appendicitis not always diagnosed in the emergency department?
A new study examines the factors associated with a potentially missed diagnosis of appendicitis in children and adults in the emergency department.

Providing contraceptive care in the pediatric emergency department
A new study found that two-thirds of female adolescents ages 16-21 seen in a pediatric Emergency Department (ED) were interested in discussing contraception, despite having a high rate of recent visits to a primary care provider.

Low back pain accounts for a third of new emergency department imaging in the US
The use of imaging for the initial evaluation of patients with low back pain in the emergency department (ED) continues to occur at a high rate -- one in three new emergency visits for low back pain in the United States -- according to the American Journal of Roentgenology (AJR).

Emergency department admissions of children for sexual abuse
This study analyzed emergency department admissions of children for sexual abuse between 2010 and 2016 using a nationwide database of emergency visits and US Census Bureau data.

30-day death rates after emergency department visits
Researchers used Medicare data from 2009 to 2016 to see how 30-day death rates associated with emergency department visits have changed.

Preventing smoking -- evidence from urban emergency department patients
A new study from the Prevention Research Center of the Pacific Institute for Research and Evaluation offers a more in-depth understanding of smoking among patients in an urban emergency department.

When a freestanding emergency department comes to town, costs go up
Rather than functioning as substitutes for hospital-based emergency departments, freestanding emergency departments have increased local market spending on emergency care in three of four states' markets where they have entered, according to a new paper by experts at Rice University.

Emoji buttons gauge emergency department sentiments in real time
Simple button terminals stationed around emergency departments featuring 'emoji' reflecting a range of emotions are effective in monitoring doctor and patient sentiments in real time.

Read More: Emergency Department News and Emergency Department Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.