Sanjay Rao1,2, Elias G Kikano3, Daniel A Smith3, Sree Harsha Tirumani3, Nikhil H Ramaiya3. 1. Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA. sxr457@case.edu. 2. Case Western Reserve University School of Medicine, 9501 Euclid Avenue, Cleveland, OH, 44118, USA. sxr457@case.edu. 3. Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Abstract
PURPOSE: Unintended weight loss (UWL) is a common presenting symptom in the emergency department (ED) with several etiologies. Our study looks to evaluate the diagnostic utility of computed tomography (CT) in the evaluation of UWL in the ED. METHODS: We identified all patients who underwent CT of the chest, abdomen, or pelvis in the ED at our institution for the diagnosis of UWL from 2004 to 2020 and retrospectively reviewed their clinical history and imaging. CT findings were organized into 4 types: (1) definite cause for UWL identified, (2) possible findings for UWL, (3) incidental findings unrelated to UWL, and (4) normal scan. Associations between clinical and laboratory findings with positive CT scans were also examined. RESULTS: One hundred seventy-three eligible patients were identified; 40 patients were excluded due to history of malignancy or inadequate follow-up. One hundred thirty-three patients were included in the final cohort. Overall, the most common causes of UWL were non-malignant gastrointestinal (GI) conditions (n = 41, 30%) and cancer (n = 30, 23%). True-positive CT findings were identified in 48.8% of patients (65/133). Elevated white blood cell counts (p = <0.0001) and physical exam abnormalities (p = 0.02) were both significantly associated with CT abnormalities. CONCLUSION: The use of CT scanning in the evaluation of UWL in the ED yielded a diagnosis in approximately half of all cases, indicating good diagnostic value. The most common causes of UWL were non-malignant GI conditions and cancer in this cohort.
PURPOSE: Unintended weight loss (UWL) is a common presenting symptom in the emergency department (ED) with several etiologies. Our study looks to evaluate the diagnostic utility of computed tomography (CT) in the evaluation of UWL in the ED. METHODS: We identified all patients who underwent CT of the chest, abdomen, or pelvis in the ED at our institution for the diagnosis of UWL from 2004 to 2020 and retrospectively reviewed their clinical history and imaging. CT findings were organized into 4 types: (1) definite cause for UWL identified, (2) possible findings for UWL, (3) incidental findings unrelated to UWL, and (4) normal scan. Associations between clinical and laboratory findings with positive CT scans were also examined. RESULTS: One hundred seventy-three eligible patients were identified; 40 patients were excluded due to history of malignancy or inadequate follow-up. One hundred thirty-three patients were included in the final cohort. Overall, the most common causes of UWL were non-malignant gastrointestinal (GI) conditions (n = 41, 30%) and cancer (n = 30, 23%). True-positive CT findings were identified in 48.8% of patients (65/133). Elevated white blood cell counts (p = <0.0001) and physical exam abnormalities (p = 0.02) were both significantly associated with CT abnormalities. CONCLUSION: The use of CT scanning in the evaluation of UWL in the ED yielded a diagnosis in approximately half of all cases, indicating good diagnostic value. The most common causes of UWL were non-malignant GI conditions and cancer in this cohort.
Authors: Christoph Metalidis; Daniël C Knockaert; Herman Bobbaers; Steven Vanderschueren Journal: Eur J Intern Med Date: 2007-11-26 Impact factor: 4.487
Authors: Lindsay E Brown; Ryan Burton; Brian Hixon; Manasi Kakade; Parul Bhagalia; Catherine Vick; Andrew Edwards; Mary T Hawn Journal: West J Emerg Med Date: 2012-11