More than 9-in-10 ED patients who receive CT of the abdomen and pelvis are clinically complex

The overwhelming majority (93.8 percent) of patients undergoing computed tomography (CT) of the abdomen and pelvis (CTAP) in the emergency department (ED) setting are classified as clinically complex, according to a study in the June issue of the Journal of the American College of Radiology. Clinically complex is used to describe patients who are, based on documentation of their ED physician, much sicker than others.

Increasing has validated the utility of CTAP in a variety of . As a result, the utilization of CTAP has increased in recent years, in both the ED and a variety of other settings, resulting in questions regarding the appropriateness of its utilization.

"Understanding the complexity of patient encounters in which advanced medical imaging services are frequently delivered might be useful in aiding payers and policymakers in explaining the growth of services over the past decade and determining the context in which these examinations are appropriately being used," said Richard Duszak, Jr., MD, co-author of the study.

Using the CMS five percent Medicare files for 2007, ED visits for Medicare fee-for-service beneficiaries were identified. Contemporaneous ED physician evaluation and management codes were used as the basis for patient complexity categorization. Encounters in which CTAP was performed on the same date of service were identified, and variables affecting the utilization of CTAP were analyzed.

Results showed that of 1,081,000 ED encounters, 306, 401 (28.3 percent) were of lower complexity and 774, 599 (71.7 percent) were of higher complexity. CT of the abdomen and was performed in 65,273 of all encounters (6.0 percent), corresponding to 4,069 (1.3 percent) of lower complexity and 61,204 (7.9 percent) of higher complexity encounters. Of the 65,273 encounters associated with CTAP, 61,204 (93.8 percent) were of higher complexity.

"The utilization of advanced in the ED setting serves many valuable roles. CT of the abdomen and pelvis can facilitate patient triage, decrease ED patient waiting times, decrease hospital lengths of stay and reduce the need for exploratory surgery. These outcomes would favor a preferential role for CTAP in sicker and more complex patients, and our results support that belief," said Duszak.

add to favorites email to friend print save as pdf

Related Stories

Emergency departments see substantial increase in CT exams

Nov 29, 2010

A new study reports that the use of computed tomography (CT) in the nation's emergency departments is growing exponentially. If the growth trend continues, by 2011, nearly 20 percent of all emergency department (ED) visits ...

Medicare and Medicaid CT scan measure is unreliable: study

Feb 23, 2012

Researchers at Brigham and Women's Hospital (BWH) have published findings that question the reliability of a new Centers for Medicare and Medicaid Services (CMS) quality measure. The study, "Assessment of Medicare's Imaging ...

Recommended for you

Experts: Chopin's heart shows signs of TB

1 hour ago

Polish medical experts say that the preserved heart of 19th century composer Frederic Chopin shows signs of tuberculosis and possibly some other lung disease.

The argument in favor of doping

3 hours ago

Ahead of Friday's court ruling on whether ASADA's investigation into the Essendon Football Club was lawful, world leader in practical and medical ethics Professor Julian Savulescu, looks at whether there is a role for performance-enhancing ...

Errata frequently seen in medical literature

Sep 16, 2014

(HealthDay)—Errata, including those that may materially change the interpretation of data, are frequent in medical publications, according to a study published in the August issue of The American Journal of ...

User comments