Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Eur J Radiol. 2021 Jul;140:109758. doi: 10.1016/j.ejrad.2021.109758. Epub 2021 May 8.
This retrospective study aims to analyze the distribution of demand and the duration of the diagnostic workup of suspected pulmonary embolism (PE) using computed tomography pulmonary angiography (CTPA).
Time data from physical examination to report creation were identified for each CTPA in 2013 and 2018 at a tertiary hospital. Multivariable multinomial logistic and linear regression models were used to evaluate differences between 3 time intervals (I1: 6am-2pm, I2: 2pm-10pm, I3: 10pm-6am). A cosinor model was applied to analyze the amount of CTPA per hour.
The relative demand for CTPA from the emergency room was lower in l1 compared to l2 and l3 (I1/I2: odds ratio (OR) 0.84, 95 % confidence interval (CI) 0.78-0.91; I1/I3: OR 0.80, 95 % CI 0.72-0.89; peak 4:23 pm). Requests for in-patients displayed a tendency towards I1 (I1/2: OR 1.15, 95 % CI 1.06-1.24; l1/l3: OR 1.19, 95 % CI 1.07-1.33; peak 1:54 pm). The time from CTPA request to study was shorter in I3 compared to I1 and I2 in 2013 (I1/I3: ratio 5.23, 95 % CI 3.38-8.10; I2/I3: ratio 3.50, 95 % CI 2.24-5.45) and 2018 (I1/I3: ratio 2.27, 95 % CI 1.60-3.22; I2/I3: ratio 2.11, 95 % CI 1.50-2.97). This applied similarly to fatal cases (I1/I3: ratio 2.91, 95 % CI 1.78-4.75; I2/I3: ratio 2.45, 95 % CI1.52-3.95).
The temporal distribution of demand for CTPA depends on the sector of patient care and the processing time differs substantially during the day. Time series analysis can reveal such coherences and may help to optimize workflows in radiology departments.
本回顾性研究旨在分析使用计算机断层肺动脉造影（CTPA）对疑似肺栓塞（PE）进行诊断的需求分布和诊断时间。
在一家三级医院，于 2013 年和 2018 年对每个 CTPA 的体格检查至报告生成时间数据进行了识别。多变量多项逻辑回归和线性回归模型用于评估 3 个时间间隔（I1：6am-2pm，I2：2pm-10pm，I3：10pm-6am）之间的差异。应用余弦模型分析每小时 CTPA 的数量。
与 I2 和 I3 相比，急诊室对 CTPA 的相对需求在 I1 时较低（I1/I2：比值比（OR）0.84，95%置信区间（CI）0.78-0.91；I1/I3：OR 0.80，95%CI 0.72-0.89；峰值 4:23pm）。住院患者的请求呈 I1 趋势（I1/2：OR 1.15，95%CI 1.06-1.24；I1/I3：OR 1.19，95%CI 1.07-1.33；峰值 1:54pm）。与 I1 和 I2 相比，2013 年和 2018 年 I3 从 CTPA 请求到研究的时间更短（I1/I3：比值 5.23，95%CI 3.38-8.10；I2/I3：比值 3.50，95%CI 2.24-5.45）。这同样适用于致命病例（I1/I3：比值 2.91，95%CI 1.78-4.75；I2/I3：比值 2.45，95%CI1.52-3.95）。
CTPA 的需求时间分布取决于患者护理部门，并且日间处理时间有很大差异。时间序列分析可以揭示这种一致性，并可能有助于优化放射科的工作流程。
