Chen J L, Dorfman G S, Li M C, Cronan J J
Department of Radiology, University of California, San Diego, USA.
Acad Radiol. 1996 Aug;3(8):678-82. doi: 10.1016/s1076-6332(96)80197-8.
Before a computed tomography (CT) scanner was installed in the emergency department, this hospital had no dedicated CT scanner for patients in the emergency department, and transporting these patients to the CT scanners in the radiology department took approximately 8-10 min each way. We sought to determine whether the presence of a CT scanner within the emergency department would lead to an increase in the number of emergent cranial CT examinations and a decrease in the diagnostic yield of these examinations.
More than 8,000 records of cranial CT examinations were reviewed for the 12 months before and the 12 months after the installation of the CT scanner in the emergency department. A positive case was defined as one that showed acute abnormality such as ischemia, hemorrhage, edema, or mass effect.
Our results show a 30.1% increase in the number of CT scans of the head ordered by physicians in the emergency department after the installation of a CT scanner (p < .0001). This is compared with the background 1.8% increase in the total number of emergency department visits. However, in both periods, 12% of the total number of head scans done were positive.
The convenience of having a CT scanner in the emergency department leads to greater use of CT examinations. However, the increase in the number of emergent CT studies is justified because the number of positive CT examinations increases proportionately.
在急诊科安装计算机断层扫描（CT）扫描仪之前，本院没有专门用于急诊科患者的CT扫描仪，将这些患者转运至放射科的CT扫描仪处，每次往返大约需要8 - 10分钟。我们试图确定急诊科配备CT扫描仪是否会导致急诊头颅CT检查数量增加以及这些检查的诊断阳性率降低。
回顾了急诊科安装CT扫描仪之前12个月和之后12个月的8000多份头颅CT检查记录。阳性病例定义为显示急性异常（如缺血、出血、水肿或占位效应）的病例。
我们的结果显示，在急诊科安装CT扫描仪后，急诊科医生开具的头部CT扫描数量增加了30.1%（p <.0001）。相比之下，急诊科就诊总数的背景增长率为1.8%。然而，在这两个时期，头部扫描总数的12%为阳性。
急诊科配备CT扫描仪带来的便利性导致CT检查的使用更加频繁。然而，急诊CT检查数量的增加是合理的，因为阳性CT检查的数量也相应增加。
