Referral of outpatients with non-traumatic conditions for radiographic examinations in an emergency department.

The aim of the study was to evaluate the referral of outpatients with non-traumatic conditions for radiographic examinations and to assess the impact of the radiological report on the patient's management in an emergency department. In a prospectively designed study, 1223 X-ray examinations of 1116 non-trauma outpatients (640 males, 476 females; mean age: 44 +/- 18 years) requested over a 10-month period were evaluated. Patients were classified into four groups according to the presenting complaints (respiratory, abdominal, neurological or non specific symptoms). Analysis of data included the influence of age and presenting symptoms on the likelihood of abnormal radiological findings and the impact of the radiological result on the further management of the patient. In 455 (40.8%) patients an abnormal radiological result was observed. The likelihood of an abnormal radiological findings increased with age (age < 40 years: 33%; age > 40 years; 47%; p < 0.05). Whereas the rate of abnormal radiological findings was high in patients with specific symptoms (respiratory: 69%; abdominal: 37%; neurological: 38%), in patients with non-specific symptoms only 25% of all radiological examinations revealed an abnormality. The radiological result had an impact on the further management in 948 (85%) patients. As 45% of all radiographic examinations revealing a normal radiological result had a clinical impact, normal radiological reports are just as helpful as abnormal radiological findings in the management of non-trauma outpatients in an emergency department. Thus, we assume that the radiological result has a major impact on the management of non-trauma outpatients in the emergency department.