Rise in CT Use in ED Curbs Admissions, Transfers

Cheryl Clark, August 11, 2011

As worrisome as radiation from CT scans is, the dramatic increase in the use of this imaging technology over12 years has averted costly admissions and patient transfers, according to a report this week in the Annals of Emergency Medicine.

Researchers in Michigan, Atlanta and New Haven looked at data from the National Hospital Medical Care Survey, a database of ED services in the United States and found that CT use increased during ED visits from 3.2% to 13.9% between 1996 and 2007.

ED visits increased about 30% over this period, "whereas CT use increased 330%, meaning the rate of CT use increased to 11 times the ED visit rate," they wrote. "And by 2007, approximately one in seven patients with an ED visit underwent a CT scan as part of their evaluation."

These increases were pegged to a variety of complaints, but the greatest percentages were seen in older patients and in those presenting with abdominal pain, flank pain, chest pain, and shortness of breath.

But by the end of the study period, the adjusted rate of hospitalization or transfer after a scan decreased from 26% in 1996 to 12.1% in 2007, or by about half.

The rate has diminished and leveled off since 2003, wrote lead author Keith Kocher, MD, of the University of Michigan in Ann Arbor, and colleagues. Admissions to an intensive care unit, among the most expensive levels of care in a hospital, declined as well.

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