Literature DB >> 23715771

Impact of routine contrast-enhanced CT on costs and use of hospital resources in patients with acute abdomen. Results of a randomised clinical trial.

Tiina Lehtimäki1, Petri Juvonen, Hannu Valtonen, Pekka Miettinen, Hannu Paajanen, Ritva Vanninen.   

Abstract

OBJECTIVES: To evaluate the costs of treatment and use of hospital resources when comparing routine abdominal CT and selective imaging practice based on clinical assessment in patients with acute abdomen.
METHODS: Altogether 300 patients with acute abdominal pain were randomised to computed tomography (CT, n = 150) or selective imaging practice (SIP, n = 150) groups. Final analysis included 254 patients, 143 in the CT and 111 in the SIP group. All CT group patients underwent contrast-enhanced abdominal CT within 24 h of admission. In the SIP group, imaging was individually tailored based on clinical assessment. The numbers of various examinations and procedures as well as costs of treatment arising from acute abdomen were calculated for each patient. Length of hospital stay was registered.
RESULTS: Total treatment cost per patient was 1,202 euros (<euro>) higher in the CT group compared to the SIP group (P = 0.002). The length of hospital stay was 1.2 days longer in the CT group (3.7 vs. 2.5 days, P = 0.010). Routine CT had no impact on ED discharge times. Imaging costs accounted for approximately 10 % of total costs.
CONCLUSION: Routine abdominal CT results in higher treatment costs compared to selective use of imaging in patients with acute abdomen. KEY POINTS: • CT is widely used almost routinely in the diagnostics of acute abdomen. • Patients with acute abdomen were randomised to routine CT or selective imaging. • The treatment costs were significantly higher in the routine CT group. • Length of hospital stay was longer in the CT group. • Selective use of imaging may help control continuous increases of treatment costs.

Entities:  

Mesh:

Substances:

Year:  2013        PMID: 23715771     DOI: 10.1007/s00330-013-2848-4

Source DB:  PubMed          Journal:  Eur Radiol        ISSN: 0938-7994            Impact factor:   5.315


  24 in total

1.  Acute abdomen of unknown origin: impact of CT on diagnosis and management.

Authors:  P Taourel; M P Baron; J Pradel; J M Fabre; E Seneterre; J M Bruel
Journal:  Gastrointest Radiol       Date:  1992

2.  The impact of helical computed tomography on the negative appendectomy rate: a multi-center comparison.

Authors:  Kyuseok Kim; Christopher C Lee; Kyoung-Jun Song; Woojeong Kim; Giljoon Suh; Adam J Singer
Journal:  J Emerg Med       Date:  2007-11-26       Impact factor: 1.484

3.  Appendectomy versus antibiotic treatment in acute appendicitis. a prospective multicenter randomized controlled trial.

Authors:  Johan Styrud; Staffan Eriksson; Ingemar Nilsson; Gunnar Ahlberg; Staffan Haapaniemi; Gunnar Neovius; Lars Rex; Ibrahim Badume; Lars Granström
Journal:  World J Surg       Date:  2006-06       Impact factor: 3.352

4.  Impact of CT on diagnosis and management of acute abdomen in patients initially treated without surgery.

Authors:  B Siewert; V Raptopoulos; M F Mueller; M P Rosen; M Steer
Journal:  AJR Am J Roentgenol       Date:  1997-01       Impact factor: 3.959

5.  Abdominal pain in the ED: stability and change over 20 years.

Authors:  R D Powers; A T Guertler
Journal:  Am J Emerg Med       Date:  1995-05       Impact factor: 2.469

6.  Appendicitis: the impact of computed tomography imaging on negative appendectomy and perforation rates.

Authors:  E J Balthazar; N M Rofsky; R Zucker
Journal:  Am J Gastroenterol       Date:  1998-05       Impact factor: 10.864

7.  Impact of abdominal helical computed tomography on the rate of negative appendicitis.

Authors:  David A Guss; Cynthia A Behling; Dominick Munassi
Journal:  J Emerg Med       Date:  2007-12-26       Impact factor: 1.484

8.  National Hospital Ambulatory Medical Care Survey: 2005 emergency department summary.

Authors:  Eric W Nawar; Richard W Niska; Jianmin Xu
Journal:  Adv Data       Date:  2007-06-29

9.  A prospective randomized study of clinical assessment versus computed tomography for the diagnosis of acute appendicitis.

Authors:  John J Hong; Stephen M Cohn; A Peter Ekeh; Martin Newman; Moises Salama; Suzanne D Leblang
Journal:  Surg Infect (Larchmt)       Date:  2003       Impact factor: 2.150

10.  Acute abdominal pain: diagnostic impact of immediate CT scanning.

Authors:  Cecilia Strömberg; Gunnar Johansson; Anders Adolfsson
Journal:  World J Surg       Date:  2007-12       Impact factor: 3.282

View more
  7 in total

1.  Appropriateness of CT scans for patients with non-traumatic acute abdominal pain.

Authors:  Kirsten J de Burlet; Matthew MacKay; Peter Larsen; Elizabeth R Dennett
Journal:  Br J Radiol       Date:  2018-06-05       Impact factor: 3.039

2.  Clinical information available during emergency department imaging order entry and radiologist interpretation.

Authors:  Tarek N Hanna; Saurabh Rohatgi; Haris N Shekhani; Ishaan Amit Dave; Jamlik-Omari Johnson
Journal:  Emerg Radiol       Date:  2017-02-27

Review 3.  Diagnostic accuracy of low-dose CT compared with abdominal radiography in non-traumatic acute abdominal pain: prospective study and systematic review.

Authors:  Muhammed Alshamari; Eva Norrman; Mats Geijer; Kjell Jansson; Håkan Geijer
Journal:  Eur Radiol       Date:  2015-09-18       Impact factor: 5.315

4.  Utility of multiple rule out CT screening of high-risk atraumatic patients in an emergency department-a feasibility study.

Authors:  Mia M Pries-Heje; Rasmus B Hasselbalch; Henriette Raaschou; Bijan Rezanavaz-Gheshlagh; Hanne Heebøll; Shazia Rehman; Mariana Kristensen; Erik Henning Andersen; Lisbet Ravn; Michel C Nèmery; Morten N Lind; Thomas Boel; Peter Sommer Ulriksen; Kasper K Iversen
Journal:  Emerg Radiol       Date:  2018-02-17

5.  Impact of clinical experience and diagnostic performance in patients with acute abdominal pain.

Authors:  Helena Laurell; Lars-Erik Hansson; Ulf Gunnarsson
Journal:  Gastroenterol Res Pract       Date:  2015-01-22       Impact factor: 2.260

6.  Performance of imaging studies in patients with suspected appendicitis after stratification with adult appendicitis score.

Authors:  Henna E Sammalkorpi; Ari Leppäniemi; Eila Lantto; Panu Mentula
Journal:  World J Emerg Surg       Date:  2017-01-31       Impact factor: 5.469

7.  Concomitant leukocytosis and lymphopenia predict significant pathology at CT of acute abdomen: a case-control study.

Authors:  Alexandra Platon; Chloe Frund; Laura Meijers; Thomas Perneger; Elisabeth Andereggen; Minerva Becker; Alice Halfon Poletti; Olivier T Rutschmann; Pierre-Alexandre Poletti
Journal:  BMC Emerg Med       Date:  2019-01-18
  7 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.