PURPOSE: Critically ill patients often require CT scans. Adverse events (AE) can occur during intra-hospital transport (IHT). The aim of this prospective study was to determine the diagnostic and therapeutic yield and the safety of CT scans in ICU patients. METHODS: All ICU patients having a CT scan for diagnostic purposes were eligible. Diagnostic yield was evaluated by the agreement (full, partial or disagreement) between the physician main diagnostic hypothesis before the CT scan and the diagnosis established after the CT scan. Therapeutic yield was assessed by therapeutic changes after the CT scan. The safety was determined by the AE rate during IHT. RESULTS: A total of 533 CT scans were performed on 359 patients in three teaching hospital ICUs. The diagnostic yield of CT scan showed 40.7 % of full agreement, 5.6 % of partial agreement and 53.7 % of disagreement with the main diagnostic hypothesis formulated before the CT scan. The CT-scan brought new elements to the diagnosis in 22.9 % of the cases. There was 54.4 % of therapeutic change after CT scan, while 22.3 % of AE occurred during IHT, including 6.7 % of life-threatening events. AE occurred more frequently in the first 48 h after ICU admission, in the most severely ill patients (higher SAPS II at admission), and when there was a large amount of equipment required for transport. CONCLUSIONS: The CT scan as a diagnostic procedure invalidated a diagnostic hypothesis and led to a therapeutic change in more than half of the cases.
PURPOSE:Critically illpatients often require CT scans. Adverse events (AE) can occur during intra-hospital transport (IHT). The aim of this prospective study was to determine the diagnostic and therapeutic yield and the safety of CT scans in ICU patients. METHODS: All ICU patients having a CT scan for diagnostic purposes were eligible. Diagnostic yield was evaluated by the agreement (full, partial or disagreement) between the physician main diagnostic hypothesis before the CT scan and the diagnosis established after the CT scan. Therapeutic yield was assessed by therapeutic changes after the CT scan. The safety was determined by the AE rate during IHT. RESULTS: A total of 533 CT scans were performed on 359 patients in three teaching hospital ICUs. The diagnostic yield of CT scan showed 40.7 % of full agreement, 5.6 % of partial agreement and 53.7 % of disagreement with the main diagnostic hypothesis formulated before the CT scan. The CT-scan brought new elements to the diagnosis in 22.9 % of the cases. There was 54.4 % of therapeutic change after CT scan, while 22.3 % of AE occurred during IHT, including 6.7 % of life-threatening events. AE occurred more frequently in the first 48 h after ICU admission, in the most severely ill patients (higher SAPS II at admission), and when there was a large amount of equipment required for transport. CONCLUSIONS: The CT scan as a diagnostic procedure invalidated a diagnostic hypothesis and led to a therapeutic change in more than half of the cases.
Authors: Daniel Lahner; Ajsa Nikolic; Peter Marhofer; Herbert Koinig; Peter Germann; Christian Weinstabl; Claus G Krenn Journal: Wien Klin Wochenschr Date: 2007 Impact factor: 1.704
Authors: Elie Azoulay; Giuseppe Citerio; Jan Bakker; Matteo Bassetti; Dominique Benoit; Maurizio Cecconi; J Randall Curtis; Glenn Hernandez; Margaret Herridge; Samir Jaber; Michael Joannidis; Laurent Papazian; Mark Peters; Pierre Singer; Martin Smith; Marcio Soares; Antoni Torres; Antoine Vieillard-Baron; Jean-François Timsit Journal: Intensive Care Med Date: 2014-01-24 Impact factor: 17.440
Authors: Maria Schroeder; Marcel Simon; Juri Katchanov; Charles Wijaya; Holger Rohde; Martin Christner; Azien Laqmani; Dominic Wichmann; Valentin Fuhrmann; Stefan Kluge Journal: Crit Care Date: 2016-05-10 Impact factor: 9.097
Authors: Marlies Ostermann; Peter A McCullough; Lui G Forni; Sean M Bagshaw; Michael Joannidis; Jing Shi; Kianoush Kashani; Patrick M Honore; Lakhmir S Chawla; John A Kellum Journal: Crit Care Med Date: 2018-03 Impact factor: 7.598
Authors: Ella F Courtie; Aditya U Kale; Benjamin T K Hui; Xiaoxuan Liu; Nicholas I Capewell; Jonathan R B Bishop; Tony Whitehouse; Tonny Veenith; Ann Logan; Alastair K Denniston; Richard J Blanch Journal: Diagnostics (Basel) Date: 2021-08-23
Authors: Alexandre Lopez; Pierre Simeone; Louis Delamarre; Gary Duclos; Charlotte Arbelot; Ines Lakbar; Bruno Pastene; Karine Bezulier; Samuel Dahan; Emilie Joffredo; Lucille Jay; Lionel Velly; Bernard Allaouchiche; Sami Hraiech; Marc Leone; Laurent Zieleskiewicz Journal: J Clin Med Date: 2022-10-05 Impact factor: 4.964