Utilization of abdominal radiography in the emergency department: Appropriateness, interpretation, radiation protection and costs.

Autor: García García P; Servicio de Radiodiagnóstico, Hospital Universitario de La Princesa, Madrid, Spain. Electronic address: patriciagarc@hotmail.com., Del Campo Del Val L; Servicio de Radiodiagnóstico, Hospital Universitario de La Princesa, Madrid, Spain; Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain., Salmerón Béliz I; Servicio de Radiodiagnóstico, Hospital Universitario de La Princesa, Madrid, Spain., Paz Calzada E; Servicio de Radiodiagnóstico, Hospital Universitario de La Princesa, Madrid, Spain., Alonso Rodríguez C; Servicio de Radiodiagnóstico, Hospital Universitario de La Princesa, Madrid, Spain., García Castañón P; Servicio de Radiofísica y Protección Radiológica, Hospital Universitario de La Princesa, Madrid, Spain., Rodríguez Carnero P; Servicio de Radiodiagnóstico, Hospital Universitario de La Princesa, Madrid, Spain; Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain.
Jazyk: angličtina
Zdroj: Radiologia [Radiologia (Engl Ed)] 2024 Jul-Aug; Vol. 66 (4), pp. 307-313. Date of Electronic Publication: 2024 Jul 17.
DOI: 10.1016/j.rxeng.2023.01.012
Abstrakt: Introduction: The use of abdominal radiography (AXR) apparently continues to be widespread despite its limited indications, the potential radiation and unnecessary costs associated. In addition, the interpretation and its report seem variable and not always performed by a radiologist. Our objective is to analyze the use, adequacy and usefulness of AXR in the emergency of a tertiary referral hospital.
Material and Methods: We retrospectively reviewed all the AXR performed in January 2020 in the emergency of our centre, as well as the patient's demographics and medical records, technical quality of the radiographs, indications according to the SERAM (Spanish Society of Radiology) Appropriateness Guidelines, presence of a formal radiology report, and impact on the clinical management of the patient. Of all non-appropriated AXR we calculated the radiation received by the patients and its extra costs.
Results: In January 2020, 429 AXR (9.1% of all radiographies) were performed in the emergency of our centre. The most frequent indication was abdominal pain (40%, n = 176), followed by low back pain (21.4%, n = 92). 12.4% of AXR requested did not include any clinical information. Most of the AXR (79.6%) had sufficient technical quality. 61.3% (n = 263) of the AXR performed were not indicated, assuming an average unjustified radiation dose per patient of 0.50 ± 0.33 mSv, and a total additional cost of 6575;. Only 6% of the inadequate AXRs led to a change in the clinical management of the patient, compared to 29% of the adequate AXR (p < 0.001). Only 3% of the AXR had a formal radiology report.
Conclusions: AXR is still common in the emergency setting, although most of them might be inadequate according to the SERAM Appropriateness Guidelines. Its use should be optimized to avoid unnecessary radiation and costs. Radiologists must have a more active participation in the management of AXR.
(Copyright © 2023 SERAM. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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