Ultra-low-dose CT versus chest X-ray for patients suspected of pulmonary disease at the emergency department

Autor: Inge A H van den Berk, Maadrika M N P Kanglie, Tjitske S R van Engelen, Josje Altenburg, Jouke T Annema, Ludo F M Beenen, Bart Boerrigter, Marije K Bomers, Paul Bresser, Elvin Eryigit, Maarten Groenink, Suzanne M R Hochheimer, Frits Holleman, Jos A J Kooter, Ramon B van Loon, Mitran Keijzers, Ivo van der Lee, Paul Luijendijk, Lilian J Meijboom, Saskia Middeldorp, Laura J Schijf, Robin Soetekouw, Ralf W Sprengers, Alexander D Montauban van Swijndregt, Wouter de Monyé, Milan L Ridderikhof, Michiel M Winter, Shandra Bipat, Marcel G W Dijkgraaf, Patrick M M Bossuyt, Jan M Prins, Jaap Stoker
Přispěvatelé: Graduate School, CCA - Imaging and biomarkers, Radiology and Nuclear Medicine, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Center of Experimental and Molecular Medicine, AII - Inflammatory diseases, APH - Quality of Care, Pulmonology, CCA - Cancer biology and immunology, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, ANS - Neurovascular Disorders, Cardiology, ACS - Heart failure & arrhythmias, General Internal Medicine, Vascular Medicine, ARD - Amsterdam Reproduction and Development, Emergency Department, 02 Surgical specialisms, AMS - Musculoskeletal Health, ACS - Diabetes & metabolism, Epidemiology and Data Science, APH - Methodology, APH - Personalized Medicine, Infectious diseases, AII - Infectious diseases, Radiology and nuclear medicine, Pulmonary medicine, Internal medicine, Surgery, VU University medical center
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Thorax. BMJ Publishing Group
OPTIMACT study group 2022, ' Ultra-low-dose CT versus chest X-ray for patients suspected of pulmonary disease at the emergency department : a multicentre randomised clinical trial ', Thorax . https://doi.org/10.1136/thoraxjnl-2021-218337
ISSN: 0040-6376
DOI: 10.1136/thoraxjnl-2021-218337
Popis: BackgroundChest CT displays chest pathology better than chest X-ray (CXR). We evaluated the effects on health outcomes of replacing CXR by ultra-low-dose chest-CT (ULDCT) in the diagnostic work-up of patients suspected of non-traumatic pulmonary disease at the emergency department.MethodsPragmatic, multicentre, non-inferiority randomised clinical trial in patients suspected of non-traumatic pulmonary disease at the emergency department. Between 31 January 2017 and 31 May 2018, every month, participating centres were randomly allocated to using ULDCT or CXR. Primary outcome was functional health at 28 days, measured by the Short Form (SF)-12 physical component summary scale score (PCS score), non-inferiority margin was set at 1 point. Secondary outcomes included hospital admission, hospital length of stay (LOS) and patients in follow-up because of incidental findings.Results2418 consecutive patients (ULDCT: 1208 and CXR: 1210) were included. Mean SF-12 PCS score at 28 days was 37.0 for ULDCT and 35.9 for CXR (difference 1.1; 95% lower CI: 0.003). After ULDCT, 638/1208 (52.7%) patients were admitted (median LOS of 4.8 days; IQR 2.1–8.8) compared with 659/1210 (54.5%) patients after CXR (median LOS 4.6 days; IQR 2.1–8.8). More ULDCT patients were in follow-up because of incidental findings: 26 (2.2%) versus 4 (0.3%).ConclusionsShort-term functional health was comparable between ULDCT and CXR, as were hospital admissions and LOS, but more incidental findings were found in the ULDCT group. Our trial does not support routine use of ULDCT in the work-up of patients suspected of non-traumatic pulmonary disease at the emergency department.Trial registration numberNTR6163.
Databáze: OpenAIRE
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