Eliminating routine oral contrast use for CT in the emergency department: Impact on patient throughput and diagnosis

被引:34
作者
Robin B. Levenson
Marc A. Camacho
Erin Horn
Amina Saghir
Daniel McGillicuddy
Leon D. Sanchez
机构
[1] Department of Radiology, Division of Emergency Radiology, Beth Israel Deaconess Medical Center, Boston
[2] Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston
[3] Department of Radiology, Division of Emergency Radiology, Cambridge, MA 02139, 632 Massachusetts Avenue
关键词
Abdominopelvic CT; Diagnosis; Emergency department; Oral contrast; Patient throughput;
D O I
10.1007/s10140-012-1059-7
中图分类号
学科分类号
摘要
This study aimed to assess the effect of eliminating routine oral contrast use for abdominopelvic (AP) computed tomography (CT) on emergency department (ED) patient throughput and diagnosis. Retrospective analysis was performed on patients undergoing AP CT during 2- month periods prior to and following oral contrast protocol change in an urban, tertiary care ED. Patients with inflammatory bowel disease, prior gastrointestinal tract-altering surgery, or lean body habitus continued to receive oral contrast. Oral contrast was otherwise eliminated from the AP CT protocol. Patients were excluded if they would not have typically received oral contrast, regardless of the intervention. Data recorded include patient demographics, ED length of stay (LOS), time from order to CT, 72-h ED return, and repeat imaging. Two thousand and one ED patients (1,014 before and 987 after protocol change) underwent AP CT during the study period. Six hundred seven preintervention and 611 post-intervention were eligible for oral contrast and included. Of these, 95 % received oral contrast prior to the intervention and 42 % thereafter. After the intervention, mean ED LOS among oral contrast eligible patients decreased by 97 min, P<0.001. Mean time from order to CT decreased by 66 min, P<0.001. No patient with CT negative for acute findings had additional subsequent AP imaging within 72 h at our institution that led to a change in diagnosis. Eliminating routine oral contrast use for AP CT in the ED may be successful in decreasing LOS and time from order to CT without demonstrated compromise in acute patient diagnosis. © Am Soc Emergency Radiol 2012.
引用
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页码:513 / 517
页数:4
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