计算机断层血管造影在下肢创伤中的应用:来自加拿大一级创伤中心的见解。

IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Jacques du Plessis, Amos Kalu, Hayley McKee, Abdelazim Mohammed, Rayane Maroun, Ferco H Berger, Gilbert Maroun
{"title":"计算机断层血管造影在下肢创伤中的应用:来自加拿大一级创伤中心的见解。","authors":"Jacques du Plessis, Amos Kalu, Hayley McKee, Abdelazim Mohammed, Rayane Maroun, Ferco H Berger, Gilbert Maroun","doi":"10.1177/08465371251342064","DOIUrl":null,"url":null,"abstract":"<p><p><b>Introduction:</b> Computed tomography angiography (CTA) plays an important role in assessing patients with suspected lower extremity traumatic vascular injury. However, CTA overutilization has been reported in some centres, and improper use has been linked to increased healthcare costs and prolonged Emergency Department wait times. This study evaluated CTA utilization in a Canadian Level I trauma centre, determined the rate of positive CTA studies requiring intervention, and identified factors that may reduce unnecessary examinations. <b>Methods and Materials:</b> This retrospective study included trauma patients who underwent lower extremity CTA between January 2020 and September 2024. Data regarding patient demographics, mechanism of injury, physical exam and computed tomography findings, ankle-brachial index value, and interventions were collected and evaluated. Statistical analysis included descriptive statistics and chi-square or Fisher's exact tests for categorical associations. <b>Results:</b> Six hundred twelve patients (82% male, median age 32 years) were included. Forty-six percent had a normal physical exam, and CTA was positive in 27% of cases. Eight percent of patients required an intervention, all of whom had at least one hard sign of vascular injury. A statistically significant association was identified between hard signs of a vascular injury and positive CTA findings (<i>P</i> < .001) and major vascular injuries (<i>P</i> < .01). No patients with a normal physical exam and a positive CTA required intervention. <b>Conclusion:</b> Nearly half of the CTA studies were performed on patients with a normal physical exam, none requiring intervention. Our findings suggest that implementing institution-specific appropriate criteria may reduce unnecessary CTA studies.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251342064"},"PeriodicalIF":2.9000,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Computed Tomography Angiography Utilization in Lower Extremity Trauma: Insights From a Canadian Level I Trauma Centre.\",\"authors\":\"Jacques du Plessis, Amos Kalu, Hayley McKee, Abdelazim Mohammed, Rayane Maroun, Ferco H Berger, Gilbert Maroun\",\"doi\":\"10.1177/08465371251342064\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Introduction:</b> Computed tomography angiography (CTA) plays an important role in assessing patients with suspected lower extremity traumatic vascular injury. However, CTA overutilization has been reported in some centres, and improper use has been linked to increased healthcare costs and prolonged Emergency Department wait times. This study evaluated CTA utilization in a Canadian Level I trauma centre, determined the rate of positive CTA studies requiring intervention, and identified factors that may reduce unnecessary examinations. <b>Methods and Materials:</b> This retrospective study included trauma patients who underwent lower extremity CTA between January 2020 and September 2024. Data regarding patient demographics, mechanism of injury, physical exam and computed tomography findings, ankle-brachial index value, and interventions were collected and evaluated. Statistical analysis included descriptive statistics and chi-square or Fisher's exact tests for categorical associations. <b>Results:</b> Six hundred twelve patients (82% male, median age 32 years) were included. Forty-six percent had a normal physical exam, and CTA was positive in 27% of cases. Eight percent of patients required an intervention, all of whom had at least one hard sign of vascular injury. A statistically significant association was identified between hard signs of a vascular injury and positive CTA findings (<i>P</i> < .001) and major vascular injuries (<i>P</i> < .01). No patients with a normal physical exam and a positive CTA required intervention. <b>Conclusion:</b> Nearly half of the CTA studies were performed on patients with a normal physical exam, none requiring intervention. Our findings suggest that implementing institution-specific appropriate criteria may reduce unnecessary CTA studies.</p>\",\"PeriodicalId\":55290,\"journal\":{\"name\":\"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes\",\"volume\":\" \",\"pages\":\"8465371251342064\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-05-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/08465371251342064\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/08465371251342064","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0

摘要

计算机断层血管造影(CTA)在评估疑似下肢创伤性血管损伤的患者中起着重要的作用。然而,据报告,在一些中心,CTA被过度使用,不当使用与医疗费用增加和急诊室等待时间延长有关。本研究评估了加拿大一级创伤中心的CTA使用情况,确定了需要干预的CTA阳性研究的比率,并确定了可能减少不必要检查的因素。方法和材料:本回顾性研究纳入了2020年1月至2024年9月期间接受下肢CTA治疗的创伤患者。收集和评估患者人口统计学、损伤机制、体格检查和计算机断层扫描结果、踝肱指数值和干预措施等数据。统计分析包括描述性统计和卡方检验或费雪精确检验。结果:纳入612例患者(82%为男性,中位年龄32岁)。46%的患者体检正常,27%的患者CTA呈阳性。8%的患者需要进行干预,所有患者都至少有一个血管损伤的明显迹象。血管损伤的硬征象和CTA阳性发现(P < 0.001)与主要血管损伤(P < 0.01)之间存在统计学上显著的关联。体格检查正常且CTA阳性的患者均无需干预。结论:近一半的CTA研究是在正常体检的患者身上进行的,不需要干预。我们的研究结果表明,实施针对特定机构的适当标准可以减少不必要的CTA研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Computed Tomography Angiography Utilization in Lower Extremity Trauma: Insights From a Canadian Level I Trauma Centre.

Introduction: Computed tomography angiography (CTA) plays an important role in assessing patients with suspected lower extremity traumatic vascular injury. However, CTA overutilization has been reported in some centres, and improper use has been linked to increased healthcare costs and prolonged Emergency Department wait times. This study evaluated CTA utilization in a Canadian Level I trauma centre, determined the rate of positive CTA studies requiring intervention, and identified factors that may reduce unnecessary examinations. Methods and Materials: This retrospective study included trauma patients who underwent lower extremity CTA between January 2020 and September 2024. Data regarding patient demographics, mechanism of injury, physical exam and computed tomography findings, ankle-brachial index value, and interventions were collected and evaluated. Statistical analysis included descriptive statistics and chi-square or Fisher's exact tests for categorical associations. Results: Six hundred twelve patients (82% male, median age 32 years) were included. Forty-six percent had a normal physical exam, and CTA was positive in 27% of cases. Eight percent of patients required an intervention, all of whom had at least one hard sign of vascular injury. A statistically significant association was identified between hard signs of a vascular injury and positive CTA findings (P < .001) and major vascular injuries (P < .01). No patients with a normal physical exam and a positive CTA required intervention. Conclusion: Nearly half of the CTA studies were performed on patients with a normal physical exam, none requiring intervention. Our findings suggest that implementing institution-specific appropriate criteria may reduce unnecessary CTA studies.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
6.20
自引率
12.90%
发文量
98
审稿时长
6-12 weeks
期刊介绍: The Canadian Association of Radiologists Journal is a peer-reviewed, Medline-indexed publication that presents a broad scientific review of radiology in Canada. The Journal covers such topics as abdominal imaging, cardiovascular radiology, computed tomography, continuing professional development, education and training, gastrointestinal radiology, health policy and practice, magnetic resonance imaging, musculoskeletal radiology, neuroradiology, nuclear medicine, pediatric radiology, radiology history, radiology practice guidelines and advisories, thoracic and cardiac imaging, trauma and emergency room imaging, ultrasonography, and vascular and interventional radiology. Article types considered for publication include original research articles, critically appraised topics, review articles, guest editorials, pictorial essays, technical notes, and letter to the Editor.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信