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量化俄亥俄州一个多中心医疗系统在新冠疫情期间急诊科影像检查使用率的下降情况。

Quantifying the decrease in emergency department imaging utilization during the COVID-19 pandemic at a multicenter healthcare system in Ohio.

作者信息

Parikh Keval D, Ramaiya Nikhil H, Kikano Elias G, Tirumani Sree Harsha, Pierce Jonathan, Butcher Carl, Sunshine Jeffrey L, Plecha Donna M

机构信息

Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA.

出版信息

Emerg Radiol. 2020 Dec;27(6):765-772. doi: 10.1007/s10140-020-01848-4. Epub 2020 Sep 1.

Abstract

PURPOSE

To illustrate the change in emergency department (ED) imaging utilization at a multicenter health system in the state of Ohio during the COVID-19 pandemic.

METHODS

A retrospective observational study was conducted assessing ED imaging volumes between March 1, 2020, and May 11, 2020, during the COVID-19 crisis. A rolling 7-day total value was used for volume tracking and comparison. Total imaging utilization in the ED was compared with new COVID-19 cases in our region. Utilization was first categorized by modality and then by plain films and computed tomography (CT) scans grouped by body part. CT imaging of the chest was specifically investigated by assessing both CT chest only exams and CT chest, abdomen, and pelvis (C/A/P) exams. Ultimately, matching pair-wise statistical analysis of exam volumes was performed to assess significance of volume change.

RESULTS

Our multicenter health system experienced a 46% drop in imaging utilization (p < 0.0001) during the pandemic. Matching pair-wise analysis showed a statistically significant volume decrease by each modality and body part. The exceptions were non-contrast chest CT, which increased (p = 0.0053), and non-trauma C/A/P CT, which did not show a statistically significant volume change (p = 0.0633).

CONCLUSION

ED imaging utilization trends revealed through actual health system data will help inform evidence-based decisions for more accurate volume predictions and therefore institutional preparedness for current and future pandemics.

摘要

目的

阐述俄亥俄州一个多中心医疗系统在2019冠状病毒病大流行期间急诊科影像检查使用情况的变化。

方法

开展一项回顾性观察研究,评估2020年3月1日至2020年5月11日2019冠状病毒病危机期间急诊科的影像检查量。采用滚动7天总值进行检查量跟踪和比较。将急诊科的总影像检查使用情况与本地区新增的2019冠状病毒病病例进行比较。首先按检查方式对使用情况进行分类,然后按普通X线片和按身体部位分组的计算机断层扫描(CT)进行分类。通过评估仅胸部CT检查和胸部、腹部及骨盆CT(C/A/P)检查,专门对胸部CT成像进行了研究。最终,对检查量进行成对匹配统计分析,以评估检查量变化的显著性。

结果

在大流行期间,我们的多中心医疗系统的影像检查使用量下降了46%(p<0.0001)。成对匹配分析显示,每种检查方式和身体部位的检查量均有统计学意义的下降。例外情况是非增强胸部CT检查量增加(p=0.0053),非创伤性C/A/P CT检查量未显示出统计学意义的变化(p=0.0633)。

结论

通过实际医疗系统数据揭示的急诊科影像检查使用趋势,将有助于为基于证据的决策提供信息,以更准确地预测检查量,从而为当前及未来的大流行做好机构准备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f030/7459244/1e75eeb70afe/10140_2020_1848_Fig1_HTML.jpg

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