Karia Monil, Seager Matthew, Rafique Akkib, Sheth Hemant
Department of Surgery and Cancer, Imperial College London, Kensington, London SW7 2AZ, UK.
Department of Surgery, Ealing Hospital, Uxbridge Road, Southall UB1 3HW, UK.
ScientificWorldJournal. 2017;2017:4028352. doi: 10.1155/2017/4028352. Epub 2017 Dec 14.
The aim of this study was to evaluate the diagnostic utility and impact on clinical management of after-hours CT scans investigating abdominal pain in surgical patients.
After-hours CT A/P reports investigating the acute surgical abdomen were compared with clinical outcomes and histopathological findings to assess sensitivity and specificity of CT reporting. Comparisons between CT reports and clinical notes were made. CT scans were categorised as having direct effects on clinical management, ruling out a serious pathology, ruling out a nonserious pathology, or having no effect. Discrepancies between information in case-notes and information provided to radiologists were also analysed.
79 clinical notes were located. After-hours CT demonstrated 91% sensitivity and 82% reporting specificity using clinical outcomes as the standard. In the 26 patients with histopathological findings, CT reports demonstrated 91% sensitivity. In 79.7% of cases, CT scanning had an impact on management. In 35.4% of cases, an indication for scanning was not documented with variation in clinical information in 8.9% of cases.
This study demonstrates after-hours CT A/P reports result in significant impacts on clinical management of surgical patients with acute abdominal pain. Improvements in providing information when requesting scans are however needed to facilitate accurate reporting.
本研究的目的是评估非工作时间腹部CT扫描对手术患者腹痛的诊断效用及其对临床管理的影响。
将非工作时间对急腹症进行的腹部CT A/P报告与临床结果及组织病理学检查结果进行比较，以评估CT报告的敏感性和特异性。对CT报告与临床记录进行比较。CT扫描被分类为对临床管理有直接影响、排除严重病变、排除非严重病变或无影响。还分析了病例记录中的信息与提供给放射科医生的信息之间的差异。
找到79份临床记录。以临床结果为标准，非工作时间腹部CT的敏感性为91%，报告特异性为82%。在26例有组织病理学检查结果的患者中，CT报告的敏感性为91%。在79.7%的病例中，CT扫描对管理有影响。在35.4%的病例中，扫描指征未记录，8.9%的病例临床信息存在差异。
本研究表明，非工作时间腹部CT A/P报告对急性腹痛手术患者的临床管理有重大影响。然而，在申请扫描时需要改进信息提供，以促进准确报告。
