Seifi Ali, Jafari Seyedmohammad, Mirmoeeni Seyyedmohammadsadeq, Azari Jafari Amirhossein, Naderi Niyousha, Safdarpour Armin, Seifi Sepehr
Department of Neurosurgery, University of Texas Health Science Center at San Antonio, San Antonio, USA.
Life Sciences, McMaster University, Toronto, CAN.
Cureus. 2022 Jun 16;14(6):e26018. doi: 10.7759/cureus.26018. eCollection 2022 Jun.
Background Although computed tomography (CT) has revolutionized the field of medicine due to its incredible diagnostic capabilities, the trends regarding the usage of CT scans, especially in the field of neuroscience, are not very clear. We aim to find the trends in the usage of inpatient head CT scans in the United States using a robust database. Methods We queried the national inpatient usage of head CT scans in the United States from 1997 to 2014 using a robust national database. The trends in usage were analyzed based on age, gender, insurance types, and patients' income. Results During the study period, we recorded a total of 5,309,329 head CT scans, of which 51% were female. The total number of head CT scans in the United States dropped significantly from 527,026 cases to 181,095 cases (p=0.000). The decrease was with a steep slope from 1997 to 2002, and since then the decreasing slope turned to a steady state. The decrease in head CT scans was significant in all age groups (p = 0.001), more significant in uninsured payers (-79.4%, p=0.000), and prominent in low-income patients (-70.5 %, p=0.000). Conclusions Our study showed that national inpatient usage of CT scans of the head significantly decreased during the past two decades. This decrease is presumably multifactorial: reducing the number of unnecessary radiations, increased appropriateness audits by the government, payers' payment reductions, and integrated electronic platforms.
背景 尽管计算机断层扫描（CT）凭借其惊人的诊断能力给医学领域带来了变革，但CT扫描的使用趋势，尤其是在神经科学领域，尚不清楚。我们旨在利用一个强大的数据库来找出美国住院患者头部CT扫描的使用趋势。
方法 我们使用一个强大的国家数据库查询了1997年至2014年美国全国住院患者头部CT扫描的使用情况。根据年龄、性别、保险类型和患者收入分析了使用趋势。
结果 在研究期间，我们共记录了5309329次头部CT扫描，其中51%为女性。美国头部CT扫描的总数从527026例显著下降至181095例（p=0.000）。1997年至2002年下降斜率陡峭，此后下降斜率转为稳定状态。所有年龄组的头部CT扫描减少均显著（p = 0.001），未参保者中减少更为显著（-79.4%，p=0.000），低收入患者中也很突出（-70.5%，p=0.000）。
结论 我们的研究表明，在过去二十年中，美国全国住院患者头部CT扫描的使用显著减少。这种减少可能是多因素导致的：减少不必要的辐射次数、政府加强适宜性审核、支付方减少支付以及集成电子平台的应用。
