Trends in CT use in an emergency department in Western Australia: 2015-2022.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Insights into Imaging Pub Date : 2025-06-04 DOI:10.1186/s13244-025-01993-9

Fouziah Almouqati, Thi Ninh Ha, Sharmani Barnard, Ashu Gupta, Elizabeth Thomas, Tracey Bhar, Colleen Taylor, Delia Hendrie

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引用次数: 0

Abstract

Objectives: We examined trends in CT use within the emergency department (ED) and their association with trends in subsequent hospital admission.

Methods: This retrospective study analyzed administrative data on episodes of adults aged 18+ years who presented to the ED of a tertiary hospital in Western Australia (WA) from March 2015 to December 2022. Adjusted annual rates of CT use and hospital admission, stratified by CT status, were estimated using multivariable regression models.

Results: Between 2015 and 2022, while the number of ED episodes increased by 8%, the number of CT scans rose by 90%. The crude rate of scans per 1000 ED episodes rose from 111 [95% CI: 108, 113] to 195 [95% CI: 192, 199]. After adjusting for variations in patients' characteristics, the rate increased from 118 [95% CI: 115, 121] to 173 [95% CI: 169, 176]. Admission rates were consistently higher for patients with CT but declined over time in both groups: from 47.6% [95% CI: 46.46, 48.75] to 42.01% [95% CI: 41.12, 42.9] for those with CT, and from 27.25% [95% CI: 26.86, 27.64] to 23.83% [95% CI: 23.47, 24.2] for those without. Compared to those without CT, the admission rate in those who underwent CT decreased by 2.17% [95% CI: 3.68, 0.66] over the period.

Conclusions: CT use in the ED has continued to increase since 2015, coinciding with a greater decrease in admissions among patients who underwent CT. The appropriateness of this increase remains undetermined, warranting further investigation.

Critical relevance statement: Given the ongoing efforts to optimize CT scan use, this study evaluates its current utilization in the emergency department and its usefulness in patient management, particularly in hospital admission.

Key points: Examining CT use and usefulness is vital given ongoing optimization efforts. CT rates rose significantly, with a clear upward shift from 2020. This coincided with a greater drop in admission for CT patients than non-CT.

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西澳大利亚州急诊科CT使用趋势：2015-2022

目的：我们研究了急诊科（ED） CT使用的趋势及其与随后住院趋势的关系。方法：本回顾性研究分析了2015年3月至2022年12月在西澳大利亚（WA）一家三级医院急诊科就诊的18岁以上成人的行政管理数据。采用多变量回归模型估计按CT状态分层的CT使用和住院率。结果：2015年至2022年间，ED发作次数增加了8%，CT扫描次数增加了90%。每1000次ED发作的粗扫描率从111次[95% CI: 108, 113]上升到195次[95% CI: 192, 199]。在调整了患者特征的变化后，发生率从118 [95% CI: 115, 121]增加到173 [95% CI: 169, 176]。接受CT的患者入院率一直较高，但随时间推移两组住院率均有所下降：接受CT的患者入院率从47.6% [95% CI: 46.46, 48.75]降至42.01% [95% CI: 41.12, 42.9]，未接受CT的患者入院率从27.25% [95% CI: 26.86, 27.64]降至23.83% [95% CI: 23.47, 24.2]。与未行CT的患者相比，在此期间，行CT的患者入院率下降了2.17% [95% CI: 3.68, 0.66]。结论：自2015年以来，CT在急诊科的使用持续增加，与接受CT治疗的患者入院率大幅下降相一致。这一增加的适当性仍未确定，需要进一步调查。关键相关性声明：考虑到优化CT扫描使用的持续努力，本研究评估其在急诊科的当前使用情况及其在患者管理中的有用性，特别是在住院治疗中。重点：鉴于正在进行的优化工作，检查CT的使用和有用性至关重要。CT率显著上升，从2020年开始明显上升。与此同时，CT患者入院率比非CT患者下降更大。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.