Burns K, Chernyak V, Scheinfeld M H
Department of Radiology, Division of Emergency Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY 10467, USA.
Department of Radiology, Division of Emergency Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY 10467, USA.
Clin Radiol. 2016 Dec;71(12):1312.e1-1312.e6. doi: 10.1016/j.crad.2016.06.117. Epub 2016 Jul 30.
To identify weather and calendar factors that would enable prediction of daily emergency department (ED) imaging volume to aid appropriate scheduling of imaging resources for efficient ED function.
Daily ED triage and imaging volumes for radiography, computed tomography (CT), and ultrasound were obtained from hospital databases for the period between January 2011 and December 2013 at a large tertiary urban hospital with a Level II trauma centre. These data were tabulated alongside daily weather conditions (temperature, wind and precipitation), day of week, season, and holidays. Multivariate analysis was performed. Pearson correlations were used to measure the association between number of imaging studies performed and ED triage volume.
For every additional 50 triaged patients, the odds of having high (imaging volume ≥90th percentile) radiography, CT, and ultrasound volume increased by 4.3 times (p<0.001), 1.5 times (p=0.02), and 1.4 times (p=0.02), respectively. Tuesday was an independent predictor of high radiography volume (odds ratio=2.8) and Monday was an independent predictor of high CT volume (odds ratio=3.0). Weekday status was an independent factor increasing the odds of a high US volume compared to Saturday (odds ratios ranging from 5.6-9.8). Weather factors and other calendar variables were not independent predictors of high imaging volume. Using Pearson correlations, ED triage volume correlated with number of radiographs, CT, and ultrasound examinations with r=0.73, 0.37, and 0.41, respectively (p<0.0001).
As ED triage volume was found to be the only factor associated with imaging volume for all techniques, analysis of predictors of ED triage volumes at a particular healthcare facility would be useful to determine imaging needs. Although calendar and weather factors were found to be minor or non-significant independent predictors of ED imaging utilisation, these may be important in influencing the actual number of ED triages.
确定天气和日历因素，以便能够预测急诊科（ED）每日的影像检查量，从而有助于合理安排影像资源，实现急诊科的高效运作。
从一家设有二级创伤中心的大型城市三级医院的医院数据库中获取了2011年1月至2013年12月期间急诊科每日的分诊量以及X线摄影、计算机断层扫描（CT）和超声检查的影像检查量。这些数据与每日天气状况（温度、风速和降水量）、星期几、季节和节假日等信息一同制成表格。进行了多变量分析。采用Pearson相关性分析来衡量影像检查数量与急诊科分诊量之间的关联。
每增加50名分诊患者，进行高量（影像检查量≥第90百分位数）X线摄影、CT和超声检查的几率分别增加4.3倍（p<0.001）、1.5倍（p=0.02）和1.4倍（p=0.02）。周二是高量X线摄影的独立预测因素（优势比=2.8），周一则是高量CT检查的独立预测因素（优势比=3.0）。与周六相比，工作日状态是增加高量超声检查几率的独立因素（优势比范围为5.6 - 9.8）。天气因素和其他日历变量并非高量影像检查的独立预测因素。使用Pearson相关性分析，急诊科分诊量与X线片数量、CT和超声检查数量的相关性分别为r=0.73、0.37和0.41（p<0.0001）。
由于发现急诊科分诊量是所有技术影像检查量的唯一相关因素，分析特定医疗机构急诊科分诊量的预测因素将有助于确定影像检查需求。尽管日历和天气因素被发现是急诊科影像检查利用的次要或非显著独立预测因素，但这些因素可能对影响急诊科实际分诊数量具有重要意义。
