Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA.
Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Emerg Radiol. 2022 Feb;29(1):1-8. doi: 10.1007/s10140-021-01994-3. Epub 2021 Nov 2.
To evaluate how the COVID-19 pandemic affected the imaging utilization patterns for non-COVID-19-related illness in a pediatric emergency department (ED).
We retrospectively reviewed radiology reports for ultrasound, CT, MRI, and fluoroscopy studies performed at a pediatric ED in April from 2017 to 2021, excluding studies for respiratory symptoms and trauma. Radiology reports and medical records were reviewed to determine if patients had a positive radiology diagnosis, the type of diagnosis, and whether it required hospital admission. Results from during the pandemic were compared to predicted rates based on pre-pandemic years.
A total of 2198 imaging studies were included. During the COVID-19 pandemic, fewer ED imaging studies were performed compared to predicted. The decrease was greater in April 2020 (RR = 0.56, p < 0.001) than in April 2021 (RR = 0.80, p = 0.038). The odds of positive diagnosis was higher during the pandemic than before, and higher in 2020 (OR 2.53, p < 0.001) than in 2021 (OR 1.38, p = 0.008). The expected numbers of positive diagnoses and hospital admittances remained within the predicted range during the pandemic (p = 0.505-0.873).
Although imaging volumes decreased during the studied months of the pandemic, the number of positive findings was unchanged compared to prior years. No differences were demonstrated in the percentage of patients admitted to the hospital with positive imaging findings. This suggests that, at our institution, the pandemic did not lead to a substantial number of missed diagnoses or severely delay the diagnosis of non-COVID-related conditions. While still lower than expected, imaging volumes increased in April 2021 suggesting a return towards baseline patient behavior as the pandemic conditions improved.
评估 COVID-19 大流行如何影响儿科急诊（ED）中非 COVID-19 相关疾病的影像学利用模式。
我们回顾性分析了 2017 年至 2021 年 4 月在儿科 ED 进行的超声、CT、MRI 和透视研究的放射学报告，排除了呼吸系统症状和创伤的研究。审查放射学报告和病历以确定患者是否有阳性放射学诊断、诊断类型以及是否需要住院治疗。将大流行期间的结果与基于大流行前年份的预测率进行比较。
共纳入 2198 项影像学研究。与预测值相比，大流行期间 ED 影像学检查数量减少。2020 年 4 月（RR=0.56，p<0.001）降幅大于 2021 年 4 月（RR=0.80，p=0.038）。大流行期间阳性诊断的可能性高于大流行前，2020 年（OR 2.53，p<0.001）高于 2021 年（OR 1.38，p=0.008）。大流行期间阳性诊断和住院人数仍在预测范围内（p=0.505-0.873）。
尽管在研究期间影像学检查数量减少，但与前几年相比，阳性检查结果数量保持不变。阳性影像学检查结果的患者住院率无差异。这表明，在我们的机构中，大流行并没有导致大量漏诊或严重延迟非 COVID 相关疾病的诊断。尽管仍低于预期，但 2021 年 4 月的影像学检查数量增加，表明随着大流行状况的改善，患者行为逐渐恢复正常。
