Published in:
01-08-2018 | Original Article
Clinical impact of computed tomography in the emergency department in nontraumatic chest and abdominal conditions
Authors:
Lorenzo Carlo Pescatori, Matteo Brambati, Carmelo Messina, Giovanni Mauri, Giovanni Di Leo, Enzo Silvestri, Francesco Sardanelli, Luca Maria Sconfienza
Published in:
Emergency Radiology
|
Issue 4/2018
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Abstract
Aim
To evaluate the clinical impact of CT scan in modifying the clinical management in patients referred to the emergency department.
Methods
We prospectively evaluated 300 patients (177 males, 63 ± 18 years old) admitted in the emergency department (ED) of a single institution, who underwent a CT examination for thoracic and/or abdominal complains. Demographic and clinical data were collected. Hypothesized outcome prior to CT scan and final management (i.e., discharge, short observation in the ED, hospitalization, and department of admission) were compared.
Results
After CT examination, a major variation in diagnosis occurred in 37% of cases and clinical management changed in 43%, occurring in 51% of patients who underwent abdominal CT, in 40% of chest CT, and in 29% of chest/abdominal CT (P = 0.015). Department of hospitalization changed in 26% of cases (P < 0.001). Clinical impact of CT scan was significantly associated (P = 0.001) with the color code at admission. In particular, the more severe was the clinical condition, the lower was the variation of management after CT examination.
Conclusions
This work confirms the crucial role of CT examination in the management of nontraumatic patients admitted to the ED, both in terms of better clarifying the diagnosis and in influencing the clinical management.