Department of Radiology, University Hospital Basel, Petersgraben 4, Basel, 4031, Switzerland.
BMC Med Imaging. 2024 Oct 21;24(1):283. doi: 10.1186/s12880-024-01457-4.
The increasing use of CT imaging in emergency departments, despite efforts of reducing low-value imaging, is not fully understood, especially during and after the COVID-19 pandemic. The aim of this study was to investigate the impact of COVID-19 pandemic related measures on trends and volume in CT examinations requested in the emergency department.
CT examinations of the head, chest, and/or abdomen-pelvis (n = 161,008), and chest radiographs (n = 113,240) performed at our tertiary care hospital between 01/2014 and 12/2023 were retrospectively analyzed. CT examinations (head, chest, abdomen, dual-region and polytrauma) and chest radiographs requested by the emergency department during (03/2020-03/2022) and after the COVID-19 pandemic (04/2022-12/2023) were compared to a pre-pandemic control period (02/2018-02/2020). Analyses included CT examinations per emergency department visit, and prediction models based on pre-pandemic trends and inpatient data. A regular expressions text search algorithm determined the most common clinical questions.
The usage of dual-region and chest CT examinations were higher during (+ 116,4% and + 115.8%, respectively; p < .001) and after the COVID-19 pandemic (+ 88,4% and + 70.7%, respectively; p < .001), compared to the control period. Chest radiograph usage decreased (-54.1% and - 36.4%, respectively; p < .001). The post-pandemic overall CT examination rate per emergency department visit increased by 4.7%. The prediction model underestimated (p < .001) the growth (dual-region CT: 22.3%, chest CT: 26.7%, chest radiographs: -30.4%), and the rise (p < .001) was higher compared to inpatient data (dual-region CT: 54.8%, chest CT: 52.0%, CR: -32.3%). Post-pandemic, the number of clinical questions to rule out "pulmonary infiltrates", "abdominal pain" and "infection focus" increased up to 235.7% compared to the control period.
Following the COVID-19 pandemic, chest CT and dual-region CT usage in the emergency department experienced a disproportionate and sustained surge compared to pre-pandemic growth.
尽管已经采取措施减少低价值的影像学检查，但急诊科中 CT 成像的使用仍在不断增加，这一现象尚未得到充分理解，尤其是在 COVID-19 大流行期间和之后。本研究旨在调查 COVID-19 大流行相关措施对急诊科 CT 检查的趋势和数量的影响。
对 2014 年 1 月至 2023 年 12 月在我们的三级护理医院进行的头部、胸部和（或）腹部-骨盆 CT 检查（n=161008 例）和胸部 X 光片（n=113240 例）进行回顾性分析。比较了 COVID-19 大流行期间（2020 年 3 月至 2022 年 3 月）和大流行之后（2022 年 4 月至 2023 年 12 月）急诊科要求的 CT 检查（头部、胸部、腹部、双区和多发伤）和胸部 X 光片，与大流行前的对照期（2018 年 2 月至 2020 年 2 月）进行比较。分析包括急诊科就诊的 CT 检查次数，以及基于大流行前趋势和住院数据的预测模型。正则表达式文本搜索算法确定了最常见的临床问题。
与对照期相比，双区和胸部 CT 检查的使用率在 COVID-19 大流行期间（分别增加了+116.4%和+115.8%；p<0.001）和之后（分别增加了+88.4%和+70.7%；p<0.001）更高。胸部 X 光片的使用率下降（分别减少了-54.1%和-36.4%；p<0.001）。每次急诊科就诊的整体 CT 检查率增加了 4.7%。预测模型低估了（p<0.001）增长率（双区 CT：22.3%，胸部 CT：26.7%，胸部 X 光片：-30.4%），并且增长（p<0.001）高于住院数据（双区 CT：54.8%，胸部 CT：52.0%，CR：-32.3%）。大流行后，排除“肺部浸润”、“腹痛”和“感染灶”的临床问题数量与对照期相比增加了 235.7%。
COVID-19 大流行后，急诊科 CT 和双区 CT 的使用与大流行前的增长相比经历了不成比例的持续增长。
