Gibson Averi L, Chen Byron Y, Rosen Max P, Paez S Nicolas, Lo Hao S
Department of Radiology, University of Massachusetts Medical School, 55 North Lake Avenue, Worcester, MA, 01655, USA.
Emerg Radiol. 2020 Dec;27(6):773-780. doi: 10.1007/s10140-020-01865-3. Epub 2020 Oct 28.
This study examined the impact of the COVID-19 pandemic on emergency department CT use for acute nontraumatic abdominal pain, to better understand why imaging volume so drastically decreased during the COVID-19 pandemic.
This was a retrospective review of emergency imaging volumes from January 5 to May 30, 2020. Weekly volume data were collected for total imaging studies, abdominopelvic CT, and abdominopelvic CTs positive for common causes of acute nontraumatic abdominal pain. Two emergency radiology attendings scored all diverticulitis cases independently, and weekly volume data for uncomplicated and complicated diverticulitis cases was also collected. Volume data prior to and during the COVID-19 pandemic was compared, using 2019 volumes as a control.
During the COVID-19 pandemic, overall emergency imaging volume decreased 30% compared to 2019 (p = 0.002). While the number of emergency abdominopelvic CTs positive for appendicitis and small bowel obstruction did not significantly change during the COVID-19 pandemic, the number of cases of diverticulitis decreased significantly compared to 2019 (p = 0.001). This reduction can be specifically attributed to decreased uncomplicated diverticulitis cases, as the number of uncomplicated diverticulitis cases dropped significantly (p = 0.002) while there was no significant difference in the number of complicated diverticulitis cases (p = 0.09).
Reduced emergency abdominopelvic CT volume during the COVID-19 pandemic can partially be explained by decreased imaging of lower acuity patients. This data may help formulate future strategies for imaging resource utilization with an improved understanding of the relationship between perceived imaging risk and symptom acuity.
本研究探讨了新冠疫情对急诊科用于急性非创伤性腹痛的CT检查的影响，以更好地理解为何在新冠疫情期间影像检查量大幅下降。
这是一项对2020年1月5日至5月30日期间急诊影像检查量的回顾性研究。收集了每周的总影像检查、腹盆腔CT以及因急性非创伤性腹痛常见病因呈阳性的腹盆腔CT的检查量数据。两名急诊放射科主治医师独立对所有憩室炎病例进行评分，并收集了单纯性和复杂性憩室炎病例的每周检查量数据。将新冠疫情之前和期间的检查量数据进行比较，以2019年的检查量作为对照。
在新冠疫情期间，急诊影像检查总量与2019年相比下降了30%（p = 0.002）。虽然在新冠疫情期间，阑尾炎和小肠梗阻呈阳性的急诊腹盆腔CT病例数没有显著变化，但憩室炎病例数与2019年相比显著下降（p = 0.001）。这种下降可具体归因于单纯性憩室炎病例的减少，因为单纯性憩室炎病例数大幅下降（p = 0.002），而复杂性憩室炎病例数没有显著差异（p = 0.09）。
新冠疫情期间急诊腹盆腔CT检查量的减少部分可归因于对病情较轻患者的影像检查减少。这些数据可能有助于制定未来影像资源利用策略，加深对感知影像风险与症状严重程度之间关系的理解。
