Document Detail


CT in detecting urinary tract calculi: influence on patient imaging and clinical outcomes.
MedLine Citation:
PMID:  12409578     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine changes in examination patterns and effectiveness of care since the introduction of unenhanced helical computed tomography (CT) for examination of patients presenting to the emergency department (ED) with symptoms of urinary tract calculi (UTC). MATERIALS AND METHODS: Hospital clinical and radiology information systems were used to retrospectively identify patients presenting with UTC symptoms from January to December 1997 (before introduction of unenhanced CT) and from January to December 1999 (after introduction of unenhanced CT). Chart abstraction was used to confirm the identification of patients with presenting symptoms suggestive of UTC and assess patient outcomes. Two hundred sixty-five patients presented before (1997) and 602 after (1999) unenhanced CT was introduced. Distributions of dichotomous variables were compared between the 1997 and 1999 groups by using logistic regression. Means were compared between the groups by using analysis of variance and mean total numbers of imaging studies by using Poisson regression. RESULTS: Total number of imaging studies increased by 26.7% per patient visit (P <.001). Rates of admission following the initial ED visit (13.7% in 1997 vs 13.4% in 1999), as well as percentage of patients who subsequently returned to the ED (12.0% in 1997 vs 13.7% in 1999) or subsequently were admitted to the hospital (4.5% in 1997 vs 5.3% in 1999) in the month following the initial ED visit, were similar between the two groups. Unsuspected unenhanced CT findings that could affect acute patient care were observed at 5.9% of examinations. CONCLUSION: Use of imaging for suspected UTC has increased markedly since the introduction of unenhanced CT, with little effect on acute care of patients in the ED.
Authors:
Ronald H Gottlieb; Thao Christine La; Erdal N Erturk; Jenny L Sotack; Susan L Voci; Robert G Holloway; Labib Syed; Igor Mikityansky; A Temel Tirkes; Rania Elmarzouky; Frank L Zwemer; Jean V Joseph; Delphine Davis; William J DiGrazio; Edward M Messing
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Radiology     Volume:  225     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-10-31     Completed Date:  2002-11-19     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  441-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright RSNA, 2002
Affiliation:
Dept of Radiology, Univ of Rochester Medical Ctr, NY 14642, USA. ronald_gottlieb@urmc.rochester.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Emergency Service, Hospital
Female
Follow-Up Studies
Hospitals, Teaching
Humans
Male
Middle Aged
New York
Patient Admission
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed*
Urinary Calculi / radiography*,  therapy
Grant Support
ID/Acronym/Agency:
5M01 RR-00044/RR/NCRR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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