Department of Radiology and Imaging Sciences, University of Utah Health, 30 North 1900 East #1A071, Salt Lake City, UT, 84132-2140, USA.
Department of Surgery, Division of Emergency Medicine, University of Utah Health, Salt Lake City, UT, USA.
Emerg Radiol. 2021 Jun;28(3):485-495. doi: 10.1007/s10140-021-01907-4. Epub 2021 Jan 30.
The COVID-19 pandemic has affected healthcare systems and patients alike across the USA. We seek to elucidate changes in abdominal imaging ordered from the emergency department (ED) in a healthcare system undergoing non-surge conditions in April 2020 compared to April 2019.
We performed a retrospective, observational study comparing patients undergoing CT scans of the abdomen and pelvis ordered from the ED in April 2020 vs. April 2019 at a single healthcare center. Via review of the radiology report and electronic medical record, we determined the positive or negative status of these scans. We evaluated percentages of positive CT scans and differences in outcomes, including admission rates, interventions, and mortality.
Comparing 2020 to 2019, there was a 31.6% decrease in the number of CT scans performed from the ED. We found a higher percentage of positive CT findings, 58.2% vs. 50.8% (p = 0.025), and increased admission rates, 40.8% vs. 34.1% (p = 0.036). Differences were found in rates of appendicitis, colitis, and cholangitis. No difference was found in ICU admissions, interventions, or in-hospital mortality.
During the COVID-19 pandemic in a region undergoing non-surge conditions, we found increased rates of positive CT scans performed from the ED for abdominal complaints with an increased percentage of hospital admissions compared to a control year. No differences in ICU admissions or rates of procedural intervention were found to suggest higher acuity of pathology on presentation. Our findings suggest appropriately decreased healthcare utilization in our study period, driven by pre-hospital patient self-selection.
COVID-19 大流行对美国各地的医疗保健系统和患者都产生了影响。我们旨在阐明在非高峰期医疗保健系统中，2020 年 4 月与 2019 年 4 月相比，急诊科（ED）下达的腹部影像学检查的变化。
我们进行了一项回顾性观察性研究，比较了在单一医疗中心，2020 年 4 月和 2019 年 4 月期间从 ED 进行的腹部和骨盆 CT 扫描的患者。通过审查放射学报告和电子病历，我们确定了这些扫描的阳性或阴性状态。我们评估了阳性 CT 扫描的百分比以及结果差异，包括入院率、干预措施和死亡率。
与 2019 年相比，2020 年 ED 进行的 CT 扫描数量减少了 31.6％。我们发现阳性 CT 结果的百分比更高，分别为 58.2％和 50.8％（p=0.025），入院率分别为 40.8％和 34.1％（p=0.036）。在阑尾炎、结肠炎和胆管炎的发生率上存在差异。在 ICU 入院、干预措施或住院死亡率方面未发现差异。
在非高峰期的 COVID-19 大流行期间，我们发现，与对照年份相比，因腹部不适而在 ED 进行的阳性 CT 扫描率增加，且入院率也增加。我们未发现 ICU 入院率或手术干预率的差异，这表明就诊时的病理变化更严重。我们的研究结果表明，在我们的研究期间，由于院前患者的自我选择，医疗保健的利用率适当减少。
