偶然发现的肺结节：遵循弗莱施纳学会监测指南的临床预测因素。
Incidentally detected lung nodules: clinical predictors of adherence to Fleischner Society surveillance guidelines.
作者信息
Ridge Carole A, Hobbs Brian D, Bukoye Bolanle A, Aronson Mark D, Boiselle Phillip M, Leffler Daniel A, Sternberg Scot B, Roberts David H
机构信息
From the *Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland; †Divisions of Pulmonary, Critical Care, and Sleep Medicine, ‡Department of Surgical Services, Boston Children's Hospital; §Department of Medicine, ∥Section of Thoracic Imaging, and ¶Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA.
出版信息
J Comput Assist Tomogr. 2014 Jan-Feb;38(1):89-95. doi: 10.1097/RCT.0b013e3182a939a5.
OBJECTIVE
The objective of this study was to determine adherence to incidentally detected lung nodule computed tomographic (CT) surveillance recommendations and identify demographic and clinical factors that increase the likelihood of CT surveillance.
MATERIALS AND METHODS
A total of 419 patients with incidentally detected lung nodules were included. Recorded data included patient demographic, radiologic, and clinical characteristics and outcomes at a 4-year follow-up. Multivariate logistic regression models determined the factors associated with likelihood of recommended CT surveillance.
RESULTS
At least 1 recommended surveillance chest CT was performed on 48% of the patients (148/310). Computed tomographic result communication to the patient (odds ratio [OR], 2.2; P = 0.006; confidence interval [CI], 1.3-4.0) or to the referring physician (OR, 2.8; P = 0.001; CI, 1.7-4.5) and recommendation of a specific surveillance time interval (OR, 1.7; P = 0.023; CI, 1.08-2.72) increased the likelihood of surveillance. Other demographic, radiologic, and clinical factors did not influence surveillance.
CONCLUSIONS
Documented physician and patient result communication as well as the recommendation of a specific surveillance time interval increased the likelihood of CT surveillance of incidentally detected lung nodules.
目的
本研究的目的是确定对偶然发现的肺结节计算机断层扫描（CT）监测建议的依从性，并确定增加CT监测可能性的人口统计学和临床因素。
材料与方法
共纳入419例偶然发现肺结节的患者。记录的数据包括患者的人口统计学、放射学和临床特征以及4年随访结果。多变量逻辑回归模型确定与推荐CT监测可能性相关的因素。
结果
48%的患者（148/310）至少进行了1次推荐的胸部CT监测。向患者传达CT结果（比值比[OR]，2.2；P = 0.006；置信区间[CI]，1.3 - 4.0）或向转诊医生传达（OR，2.8；P = 0.001；CI，1.7 - 4.5）以及推荐特定的监测时间间隔（OR，1.7；P = 0.023；CI，1.08 - 2.72）增加了监测的可能性。其他人口统计学、放射学和临床因素不影响监测。
结论
记录在案的医生与患者之间的结果沟通以及推荐特定的监测时间间隔增加了对偶然发现的肺结节进行CT监测的可能性。
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