Chang Ikwan, Jung Jae Yun, Kwak Young Ho, Kim Do Kyun, Lee Jin Hee, Jung Jin Hee, Kwon Hyuksool, Paek So Hyun, Park Joong Wan
Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Clin Exp Emerg Med. 2018 Jan 31;5(1):35-42. doi: 10.15441/ceem.16.192. eCollection 2018 Mar.
Many studies have proposed reducing unnecessary use of computed tomography (CT), and ongoing studies in pediatric populations are aiming to decrease radiation dosages whenever possible. We aimed to evaluate the long-term changes in the utilization patterns of CT and ultrasound (US) in pediatric emergency departments (PEDs).
This retrospective study reviewed the electronic medical data of patients who underwent CT and/or US in the PED of a tertiary referral hospital from 2000 to 2014. We compared the changes in utilization patterns of brain and abdominal CT scans in pediatric patients and analyzed changes in abdominal US utilization in the PED.
During the study period, 196,371 patients visited the PED. A total of 12,996 brain and abdominal CT scans and 12,424 abdominal US were performed in the PED. Comparison of CT use in pediatric patients before and after 2007 showed statistically decreasing trends after 2007, expressed as the coefficient values of the differences in groups. The numbers of brain and abdominal CT scans showed a significant decreasing trend in children, except for abdominal CT in adolescents. The abdominal US/CT ratio in the PED showed a statistically significant increase (2.68; 95% confidence interval, 1.87 to 3.49) except for the adolescent group (5.82; 95% confidence interval, -2.06 to 13.69).
Overall, CT use in pediatric patients has decreased since 2007. Pediatric US use has also shown a decreasing trend; however, the abdominal US/CT ratio in pediatric patients showed an increasing trend, except for adolescents.
许多研究都提议减少计算机断层扫描（CT）的不必要使用，并且针对儿科人群的正在进行的研究旨在尽可能降低辐射剂量。我们旨在评估儿科急诊科（PED）中CT和超声（US）使用模式的长期变化。
这项回顾性研究回顾了2000年至2014年在一家三级转诊医院的PED接受CT和/或US检查的患者的电子医疗数据。我们比较了儿科患者脑部和腹部CT扫描使用模式的变化，并分析了PED中腹部超声使用情况的变化。
在研究期间，有196,371名患者前往PED就诊。PED共进行了12,996次脑部和腹部CT扫描以及12,424次腹部超声检查。比较2007年前后儿科患者的CT使用情况，2007年后显示出统计学上的下降趋势，以组间差异的系数值表示。除青少年腹部CT外，儿童脑部和腹部CT扫描的次数呈显著下降趋势。PED中的腹部超声/CT比值显示出统计学上的显著增加（2.68；95%置信区间，1.87至3.49），青少年组除外（5.82；95%置信区间，-2.06至13.69）。
总体而言，自2007年以来儿科患者的CT使用量有所下降。儿科超声的使用也呈下降趋势；然而，儿科患者的腹部超声/CT比值呈上升趋势，青少年除外。
