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Med Care. 2009 Jul;47(7):782-6. doi: 10.1097/MLR.0b013e31819748e9.

Trends in the rates of radiography use and important diagnoses in emergency department patients with abdominal pain.

Author information

  • Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. pinesjes@uphs.upenn.edu

Abstract

BACKGROUND:

Computed tomography (CT) and ultrasound (US) are used in emergency departments (ED) to aid in the diagnosis of patients with abdominal pain.

OBJECTIVES:

To describe trends in CT and US use in United States EDs and determine if higher test use is associated with higher detection rates for intra-abdominal illnesses commonly detected on CT and US and lower hospital admission rates.

RESEARCH DESIGN:

Retrospective study using the 2001 to 2005 National Hospital Ambulatory Medical Care Survey, a nationally representative sample of ED encounters.

SUBJECTS:

ED patients presenting with abdominal pain.

MEASURES:

Annual rates of and trends in CT and US use, rates of intra-abdominal illnesses, hospital admission rate.

RESULTS:

Abdominal pain visits accounted for 38.8 million encounters; 17.8% received a CT and 11.7% received an US. CT use increased from 10.1% in 2001 to 22.5% in 2005 (P < 0.001). US use increased from 11.1% in 2001 to 13.6% in 2005 (P = 0.002). During the same period, detection rates for appendicitis, diverticulitis, and gall bladder disease did not increase and admission rates did not decrease.

CONCLUSION:

Despite a more than doubling in CT use and increases in US use, there was no increase in detection rates for appendicitis, diverticulitis, and gall bladder disease nor was there a reduction in admissions.

PMID:
19536032
[PubMed - indexed for MEDLINE]
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