Substantial increase in CT exams seen in emergency departments

The use of CT in emergency rooms across the nation is growing exponentially, according to a study published online in Radiology.

According to investigators for the study, nearly 20% of all emergency department (ED) visits may involve a CT exam by 2011.

“It is not surprising that CT utilization has increased,” David B. Larson, MD, MBA, a lead investigator for the study, stated in a press release. “What’s surprising is the sustained high rate of that growth. However, recent developments, such as increased awareness of cost, radiation concerns, national health care reform legislation and the economic recession, are likely to inhibit future growth.”

Six-fold increase

Larson’s team used data collected by the National Hospital Ambulatory Medical Care Survey from 1995 through 2007 to identify nationwide trends associated with CT used in the ED. The investigators performed statistical analysis on a mean of 30,044 ED visits from each year during the 13-year period to estimate overall CT use.

The team found the number of ED visits that included a CT exam increased from 2.7 million in 1995 to 16.2 million in 2007 – a near six-fold increase and an average growth rate of 16% per year.

Furthermore, the percentage of ED visits involving a CT exam rose from 2.8% in 1995 to 13.9% in 2007.

“We have seen a remarkable growth in CT utilization, not only in the number of ED visits that involve CT imaging but in the percentage of patients walking into the ED that receive a CT,” Larson stated in the release.

Exercise caution in CT use

Reportedly, headache was the complaint most commonly associated with a CT exam in the ED during the 13-year period. However, by 2007, headache was surpassed by abdominal pain. The investigators noted that patients with abdominal pain represented 12.8% of all ED visits involving CT in 2007.

The study found that, overall, the use of CT for complaints that are typically related to exams with a higher radiation dose grew faster than those typically related to exams with lower radiation doses – suggesting that the radiation dose associated with CT in the ED may be growing at a faster rate than the growth in the overall use of CT.

The authors added that a patient visiting the ED with chest pains in 1995 would rarely receive a CT exam, while 2007 results showed that chest pain was the third most common complaint in the ED associated with CT imaging.

“Our emphasis now should be on carefully evaluating the use of CT in specific situations and making sure it is used appropriately,” Larson stated.

Reference:
Larson DB. Radiol. Published online before print November 29, 2010. doi: 10.1148/radiol.10100640.

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