Trends in computed tomography utilization and association with hospital outcomes in a Chinese emergency department.

<h4>Background</h4>Excessive use of computed tomography (CT) in emergency departments (EDs) has become a concern due to its expense and the potential risks associated with radiation exposure. Although studies have shown a steady increase in the number of CT scans requested by ED physicia...

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Autores principales:	Jian-Cang Zhou, San-Wei Zheng, Yun-Xian Yu, Keith Rouleau, Wei-Liang Jiang, Chong-Wu Jin, Dao-Yang Zhou, Kong-Han Pan, Yun-Song Yu
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/48e43e26067242189aa76ac61a5135ce
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spelling	oai:doaj.org-article:48e43e26067242189aa76ac61a5135ce2021-11-18T07:12:41ZTrends in computed tomography utilization and association with hospital outcomes in a Chinese emergency department.1932-620310.1371/journal.pone.0040403https://doaj.org/article/48e43e26067242189aa76ac61a5135ce2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22808154/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Excessive use of computed tomography (CT) in emergency departments (EDs) has become a concern due to its expense and the potential risks associated with radiation exposure. Although studies have shown a steady increase in the number of CT scans requested by ED physicians in developed countries like the United States and Australia, few empirical data are available regarding China.<h4>Methods and findings</h4>We retrospectively analyzed a database of ED visits to a tertiary Chinese hospital to examine trends in CT utilization and their association with ED outcomes between 2005 and 2008. A total of 197,512 ED visits were included in this study. CT utilization increased from 9.8% in 2005 to 13.9% in 2008 (P<.001 for trend). The ED length of stay for visits with CT utilization was 0.6 hour longer than those in which CT was not obtained. CT utilization increased the ED cost by an average $48.2. After adjustment for patients' demographics, arrival hours and clinical condition, CT utilization during ED visits was significantly associated with high ED cost (Odds Ratio [OR]: 21.70; 95% confidence interval [CI], 17.00-27.71), long ED length of stay (OR: 1.22; 95%CI, 1.12-1.34), and more likely to receive emergency operations (OR: 2.31; 95%CI, 1.94-2.76). However, there was no significant correlation between CT use and the possibility to be admitted to inpatient wards (OR: 0.82; 95%CI, 0.65-1.04). With respect to the time-related trends, CT utilization during ED visits in all study years was significantly associated with high ED cost and more likely to receive emergency operations.<h4>Conclusion</h4>CT utilization was associated with higher ED cost, longer ED length of stay and more likely to receive emergency operations, but did not correlate with a significant change in the admission rate.Jian-Cang ZhouSan-Wei ZhengYun-Xian YuKeith RouleauWei-Liang JiangChong-Wu JinDao-Yang ZhouKong-Han PanYun-Song YuPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 7, p e40403 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jian-Cang Zhou San-Wei Zheng Yun-Xian Yu Keith Rouleau Wei-Liang Jiang Chong-Wu Jin Dao-Yang Zhou Kong-Han Pan Yun-Song Yu Trends in computed tomography utilization and association with hospital outcomes in a Chinese emergency department.
description	<h4>Background</h4>Excessive use of computed tomography (CT) in emergency departments (EDs) has become a concern due to its expense and the potential risks associated with radiation exposure. Although studies have shown a steady increase in the number of CT scans requested by ED physicians in developed countries like the United States and Australia, few empirical data are available regarding China.<h4>Methods and findings</h4>We retrospectively analyzed a database of ED visits to a tertiary Chinese hospital to examine trends in CT utilization and their association with ED outcomes between 2005 and 2008. A total of 197,512 ED visits were included in this study. CT utilization increased from 9.8% in 2005 to 13.9% in 2008 (P<.001 for trend). The ED length of stay for visits with CT utilization was 0.6 hour longer than those in which CT was not obtained. CT utilization increased the ED cost by an average $48.2. After adjustment for patients' demographics, arrival hours and clinical condition, CT utilization during ED visits was significantly associated with high ED cost (Odds Ratio [OR]: 21.70; 95% confidence interval [CI], 17.00-27.71), long ED length of stay (OR: 1.22; 95%CI, 1.12-1.34), and more likely to receive emergency operations (OR: 2.31; 95%CI, 1.94-2.76). However, there was no significant correlation between CT use and the possibility to be admitted to inpatient wards (OR: 0.82; 95%CI, 0.65-1.04). With respect to the time-related trends, CT utilization during ED visits in all study years was significantly associated with high ED cost and more likely to receive emergency operations.<h4>Conclusion</h4>CT utilization was associated with higher ED cost, longer ED length of stay and more likely to receive emergency operations, but did not correlate with a significant change in the admission rate.
format	article
author	Jian-Cang Zhou San-Wei Zheng Yun-Xian Yu Keith Rouleau Wei-Liang Jiang Chong-Wu Jin Dao-Yang Zhou Kong-Han Pan Yun-Song Yu
author_facet	Jian-Cang Zhou San-Wei Zheng Yun-Xian Yu Keith Rouleau Wei-Liang Jiang Chong-Wu Jin Dao-Yang Zhou Kong-Han Pan Yun-Song Yu
author_sort	Jian-Cang Zhou
title	Trends in computed tomography utilization and association with hospital outcomes in a Chinese emergency department.
title_short	Trends in computed tomography utilization and association with hospital outcomes in a Chinese emergency department.
title_full	Trends in computed tomography utilization and association with hospital outcomes in a Chinese emergency department.
title_fullStr	Trends in computed tomography utilization and association with hospital outcomes in a Chinese emergency department.
title_full_unstemmed	Trends in computed tomography utilization and association with hospital outcomes in a Chinese emergency department.
title_sort	trends in computed tomography utilization and association with hospital outcomes in a chinese emergency department.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/48e43e26067242189aa76ac61a5135ce
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Trends in computed tomography utilization and association with hospital outcomes in a Chinese emergency department.

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