Medical Imaging Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
J Med Imaging Radiat Oncol. 2020 Aug;64(4):496-498. doi: 10.1111/1754-9485.13053. Epub 2020 Jun 7.
The aim of this study was to study how the effect of eliminating oral contrast for computed tomography of the abdomen and pelvis (CTAP) in the workup of abdominal pain in the emergency department (ED) would affect the time from patient review to scan and time from review to discharge.
In this retrospective study, we analysed all ED presentations with abdominal pain to our university affiliated tertiary hospital before and after a protocol that eliminated oral contrast-enhanced CTAPs were implemented in September 2018. Two equivalent periods between September and November of 2017 and 2018 were analysed. Patients were excluded if they had a history of anatomy-altering gastrointestinal surgery, history of inflammatory bowel disease, trauma, suspicion of foreign body ingestion or suspected gastrointestinal bleeding.
A total of 176 pre-protocol and 197 post-protocol patients were included in the study. We found that the elimination of oral contrast was associated with a decrease in mean time between ED review and scan by 110 min (379 vs. 269 min). We also found that the elimination of oral contrast did not significantly alter the pattern of radiological diagnoses seen between the two study periods, suggesting the absence of oral contrast does not affect diagnostic accuracy.
Thus, eliminating the use of oral contrast in the workup of abdominal pain in the ED can lead to increased throughput and more timely patient care.
本研究旨在研究在急诊科（ED）腹痛的检查中消除口服对比剂对腹部和骨盆计算机断层扫描（CTAP）的影响如何改变从患者评估到扫描的时间和从评估到出院的时间。
在这项回顾性研究中，我们分析了 2018 年 9 月实施消除口服增强 CTAP 方案前后，我们大学附属医院 ED 所有以腹痛为主诉的就诊患者。分析了 2017 年 9 月至 11 月和 2018 年 9 月至 11 月两个等效时间段的患者数据。如果患者有改变胃肠道解剖结构的手术史、炎症性肠病史、创伤史、怀疑异物摄入或疑似胃肠道出血，则将其排除在外。
本研究共纳入 176 例方案前和 197 例方案后患者。我们发现，消除口服对比剂与 ED 评估与扫描之间的平均时间减少了 110 分钟（379 分钟比 269 分钟）。我们还发现，消除口服对比剂并没有显著改变两个研究期间所见的放射学诊断模式，表明没有口服对比剂并不影响诊断准确性。
因此，在 ED 腹痛的检查中消除口服对比剂的使用可以提高工作效率并更及时地进行患者护理。
