Department of Emergency Medicine, St Luke's Roosevelt Hospital Center, New York, NY 10019, USA.
Ann Emerg Med. 2010 Dec;56(6):591-6. doi: 10.1016/j.annemergmed.2010.05.027.
There is both increasing recognition and growing scrutiny of the increased utilization of computed tomography (CT) in medicine. For our primary objective, we determine and quantify the CT utilization rate in our emergency department (ED) during the last 7 years. As a secondary objective, we compare trends in utilization for various types of CT scans.
We performed an electronic chart review at our inner-city, academic ED with an annual census of 110,000 patients. We identified all patients older than 21 years who had a CT scan performed during ED management from January 2001 to December 2007. Specific, predetermined data elements (eg, subject demographics, type of CT scan) were extracted on standardized data forms by trained abstractors. We analyzed our data with standard descriptive statistics and linear regression.
The rate of CT utilization increased steadily at approximately 10 CTs per 1,000 (95% confidence interval 7.5 to 13.6 CTs) patients annually during our study period, from 51 per 1,000 patient visits in 2001 to 106 per 1,000 in 2007. Among these CTs, chest CTs increased most, with a 6-fold increase from 1 [corrected] per 1,000 patient visits to 6 [corrected] per 1,000. Neck CTs increased by 5-fold, from 2 [corrected] per 1,000 patient visits to 10 [corrected] per 1,000 patients. Similarly, the utilization of abdomen-pelvis CTs, facial bone CTs, and head CTs increased from 13 per 1,000 to 33 per 1,000 patient visits (150%), 1 per 1,000 to 2 per 1,000 patient visits (100%), and 33 per 1,000 to 53 per 1,000 patient visits (60%), respectively.
Recent CT utilization in our ED increased in all anatomic categories assessed, with chest CTs and neck CTs increasing the most, followed by abdomen-pelvis CTs, facial bone CTs, and head CTs.
人们越来越认识到并越来越关注医学中计算机断层扫描（CT）的使用增加。我们的主要目标是确定并量化过去 7 年我们急诊科（ED）的 CT 使用量。作为次要目标，我们比较各种类型 CT 扫描的使用趋势。
我们在内城学术 ED 进行了电子病历回顾，每年有 110,000 名患者。我们确定了所有年龄大于 21 岁的在 ED 管理期间进行 CT 扫描的患者，时间为 2001 年 1 月至 2007 年 12 月。由受过培训的摘要员在标准化数据表格上提取特定的、预定的数据元素（例如，主题人口统计学、CT 扫描类型）。我们使用标准描述性统计和线性回归分析我们的数据。
在我们的研究期间，CT 使用率稳步增加，每年约每 1,000 名患者增加 10 次 CT（95%置信区间 7.5 至 13.6 CT），从 2001 年每 1,000 名患者就诊 51 次增加到 2007 年每 1,000 名患者就诊 106 次。在这些 CT 中，胸部 CT 增加最多，从每 1,000 名患者就诊 1 次增加到每 1,000 名患者就诊 6 次。颈部 CT 增加了 5 倍，从每 1,000 名患者就诊 2 次增加到每 1,000 名患者就诊 10 次。同样，腹部-骨盆 CT、面部骨 CT 和头部 CT 的使用率从每 1,000 名患者就诊 13 次增加到每 1,000 名患者就诊 33 次（增加 150%），从每 1,000 名患者就诊 1 次增加到每 1,000 名患者就诊 2 次（增加 100%），从每 1,000 名患者就诊 33 次增加到每 1,000 名患者就诊 53 次（增加 60%）。
我们 ED 最近的 CT 使用在评估的所有解剖类别中均增加，其中胸部 CT 和颈部 CT 增加最多，其次是腹部-骨盆 CT、面部骨 CT 和头部 CT。
