Anand M Prabhakar1, Alexander S Misono2, H Benjamin Harvey2, Brian J Yun3, Sanjay Saini2, Rahmi Oklu4. 1. Division of Cardiovascular Imaging and Emergency Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: aprabhakar@partners.org. 2. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 3. Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 4. Division of Vascular Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Abstract
OBJECTIVES: This study aims to determine the use of diagnostic imaging in emergency department (ED) observation units, particularly relative to inpatients admitted from the ED. STUDY DESIGN: Retrospective, descriptive analysis. METHODS: Our database of ED patients was retrospectively reviewed to identify patients managed in the observation unit or admitted to inpatient services. In February 2014, we randomly selected 105 ED observation patients and 108 patients admitted to inpatient services from the ED. Electronic medical records were reviewed to assess diagnosis as well as type and quantity of imaging tests obtained. RESULTS: Eighty (76%) ED observation patients underwent imaging tests (radiographs, 39%; computed tomography, 25%; magnetic resonance imaging (MRI), 24%; ultrasound, 8%; other, 4%); 85 inpatients (79%) underwent imaging tests while in the ED (radiographs, 52%; computed tomography, 30%; MRI, 8%; ultrasound, 9%; other, 1%). There was no significant difference in overall imaging use between ED observation patients and inpatients, but ED observation patients were more likely to undergo MRI (P=.0243). The most common presenting diagnoses to the ED observation unit were neurologic complaints (25%), abdominal pain (17%), and cardiac symptoms (16%). CONCLUSION: There is no difference in the overall use of imaging in patients transferred to the ED observation unit vs those directly admitted from the ED. However, because ED observation unit patients tend to be accountable for a higher proportion of their health care bill, the impact of imaging in these patients is likely substantive.
OBJECTIVES: This study aims to determine the use of diagnostic imaging in emergency department (ED) observation units, particularly relative to inpatients admitted from the ED. STUDY DESIGN: Retrospective, descriptive analysis. METHODS: Our database of ED patients was retrospectively reviewed to identify patients managed in the observation unit or admitted to inpatient services. In February 2014, we randomly selected 105 ED observation patients and 108 patients admitted to inpatient services from the ED. Electronic medical records were reviewed to assess diagnosis as well as type and quantity of imaging tests obtained. RESULTS: Eighty (76%) ED observation patients underwent imaging tests (radiographs, 39%; computed tomography, 25%; magnetic resonance imaging (MRI), 24%; ultrasound, 8%; other, 4%); 85 inpatients (79%) underwent imaging tests while in the ED (radiographs, 52%; computed tomography, 30%; MRI, 8%; ultrasound, 9%; other, 1%). There was no significant difference in overall imaging use between ED observation patients and inpatients, but ED observation patients were more likely to undergo MRI (P=.0243). The most common presenting diagnoses to the ED observation unit were neurologic complaints (25%), abdominal pain (17%), and cardiac symptoms (16%). CONCLUSION: There is no difference in the overall use of imaging in patients transferred to the ED observation unit vs those directly admitted from the ED. However, because ED observation unit patients tend to be accountable for a higher proportion of their health care bill, the impact of imaging in these patients is likely substantive.
Authors: Andrew L Callen; Sara M Dupont; Adi Price; Ben Laguna; David McCoy; Bao Do; Jason Talbott; Marc Kohli; Jared Narvid Journal: J Digit Imaging Date: 2020-08-19 Impact factor: 4.056
Authors: Yadiel Sánchez; Brian J Yun; Anand M Prabhakar; McKinley Glover; Benjamin A White; Theodore I Benzer; Ali S Raja Journal: West J Emerg Med Date: 2017-07-19
Authors: McKinley Glover; Ravi V Gottumukkala; Yadiel Sanchez; Brian J Yun; Theodore I Benzer; Benjamin A White; Anand M Prabhakar; Ali S Raja Journal: West J Emerg Med Date: 2018-04-05