Kim Seul Ki, Jung Jin Hee, Lee Jin Hee, Jung Jae Yun, Kwon Hyuksool, Paek So Hyun, Kwak Young Ho, Kim Do Kyun
Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Emergency Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
Clin Exp Emerg Med. 2019 Mar;6(1):19-24. doi: 10.15441/ceem.17.274. Epub 2019 Feb 20.
The use of computed tomography (CT) in pediatric patients has decreased since the association between radiation and cancer risk has been reported. However, in adolescent patients being treated as adult patients, there has been a high incidence of CT use in emergency departments (EDs). Thus, this study aimed to evaluate the CT use in adolescent patients with complaints of headache or abdominal pain in the general and pediatric EDs of the same hospital.
A retrospective chart review of patients aged 15 to 18 years, who presented with headache or abdominal pain at the general and pediatric EDs of Seoul National University Hospital from January 2010 to December 2014, was conducted.
A total of 407 adolescent patients with complaints of headache and 980 with abdominal pain were included in this study. The adolescent patients in the general ED were more likely to undergo CT scans than those in the pediatric ED, with both patients having headache (42.4% vs. 20.5%, respectively, P<0.001) and abdominal pain (29.0% vs. 18.4%, respectively, P<0.001). There was no statistical difference in the rates of positive CT findings between the general and pediatric EDs. The frequency of visits to the general ED was associated with high rates of CT use in adolescent patients with complaints of headache (odds ratio, 3.95; 95% confidence interval, 2.01 to 7.77) and those with abdominal pain (odds ratio, 1.76; 95% confidence interval, 1.18 to 2.64).
The ED setting influences the use of CT on adolescent patients, and a child-friendly environment could reduce the radiation risks.
自辐射与癌症风险之间的关联被报道以来，儿科患者中计算机断层扫描（CT）的使用有所减少。然而，在按成人患者治疗的青少年患者中，急诊科（ED）的CT使用率一直很高。因此，本研究旨在评估同一家医院普通急诊科和儿科急诊科中因头痛或腹痛就诊的青少年患者的CT使用情况。
对2010年1月至2014年12月在首尔国立大学医院普通急诊科和儿科急诊科因头痛或腹痛就诊的15至18岁患者进行回顾性病历审查。
本研究共纳入407例主诉头痛的青少年患者和980例主诉腹痛的青少年患者。普通急诊科的青少年患者比儿科急诊科的患者更有可能接受CT扫描，无论是头痛患者（分别为42.4%和20.5%，P<0.001）还是腹痛患者（分别为29.0%和18.4%，P<0.001）。普通急诊科和儿科急诊科的CT阳性发现率无统计学差异。普通急诊科的就诊频率与主诉头痛的青少年患者（优势比，3.95；95%置信区间，2.01至7.77）和主诉腹痛的青少年患者（优势比，1.76；95%置信区间，1.18至2.64）的高CT使用率相关。
急诊科环境会影响青少年患者的CT使用情况，营造儿童友好型环境可降低辐射风险。
