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      Long-term changes in computed tomography and ultrasound utilization in a pediatric emergency department

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      https://www.riss.kr/link?id=A106144285

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      다국어 초록 (Multilingual Abstract)

      Objective Many studies have proposed reducing unnecessary use of computed tomography (CT), and ongoing studies in pediatric populations are aiming to decrease radiation dosages whenever possible. We aimed to evaluate the long-term changes in the utili...

      Objective Many studies have proposed reducing unnecessary use of computed tomography (CT), and ongoing studies in pediatric populations are aiming to decrease radiation dosages whenever possible. We aimed to evaluate the long-term changes in the utilization patterns of CT and ultrasound (US) in pediatric emergency departments (PEDs).
      Methods This retrospective study reviewed the electronic medical data of patients who underwent CT and/or US in the PED of a tertiary referral hospital from 2000 to 2014. We compared the changes in utilization patterns of brain and abdominal CT scans in pediatric patients and analyzed changes in abdominal US utilization in the PED.
      Results During the study period, 196,371 patients visited the PED. A total of 12,996 brain and abdominal CT scans and 12,424 abdominal US were performed in the PED. Comparison of CT use in pediatric patients before and after 2007 showed statistically decreasing trends after 2007, expressed as the coefficient values of the differences in groups. The numbers of brain and abdominal CT scans showed a significant decreasing trend in children, except for abdominal CT in adolescents.
      The abdominal US/CT ratio in the PED showed a statistically significant increase (2.68; 95% confidence interval, 1.87 to 3.49) except for the adolescent group (5.82; 95% confidence interval, -2.06 to 13.69).
      Conclusion Overall, CT use in pediatric patients has decreased since 2007. Pediatric US use has also shown a decreasing trend; however, the abdominal US/CT ratio in pediatric patients showed an increasing trend, except for adolescents.

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      참고문헌 (Reference)

      1 Blitman NM, "Value of focused appendicitis ultrasound and alvarado score in predicting appendicitis in children: can we reduce the use of CT?" 204 : W707-W712, 2015

      2 오혜연, "Trends of CT Use in the Pediatric Emergency Department in a Tertiary Academic Hospital of Korea during 2001-2010" 대한영상의학회 13 (13): 771-775, 2012

      3 오혜연, "Trends of CT Use in the Adult Emergency Department in a Tertiary Academic Hospital of Korea during 2001-2010" 대한영상의학회 13 (13): 536-540, 2012

      4 Hess EP, "Trends in computed tomography utilization rates: a longitudinal practice-based study" 10 : 52-58, 2014

      5 Menoch MJ, "Trends in computed tomography utilization in the pediatric emergency department" 129 : 690-697, 2012

      6 Miglioretti DL, "The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk" 167 : 700-707, 2013

      7 Wakeford R, "The risk of childhood leukaemia following exposure to ionizing radiation: a review" 33 : 1-25, 2013

      8 Kirpalani H, "Radiation risk to children from computed tomography" 121 : 449-450, 2008

      9 Brody AS, "Radiation risk to children from computed tomography" 120 : 677-682, 2007

      10 Boutis K, "Radiation exposure from imaging tests in pediatric emergency medicine: a survey of physician knowledge and risk disclosure practices" 47 : 36-44, 2014

      1 Blitman NM, "Value of focused appendicitis ultrasound and alvarado score in predicting appendicitis in children: can we reduce the use of CT?" 204 : W707-W712, 2015

      2 오혜연, "Trends of CT Use in the Pediatric Emergency Department in a Tertiary Academic Hospital of Korea during 2001-2010" 대한영상의학회 13 (13): 771-775, 2012

      3 오혜연, "Trends of CT Use in the Adult Emergency Department in a Tertiary Academic Hospital of Korea during 2001-2010" 대한영상의학회 13 (13): 536-540, 2012

      4 Hess EP, "Trends in computed tomography utilization rates: a longitudinal practice-based study" 10 : 52-58, 2014

      5 Menoch MJ, "Trends in computed tomography utilization in the pediatric emergency department" 129 : 690-697, 2012

      6 Miglioretti DL, "The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk" 167 : 700-707, 2013

      7 Wakeford R, "The risk of childhood leukaemia following exposure to ionizing radiation: a review" 33 : 1-25, 2013

      8 Kirpalani H, "Radiation risk to children from computed tomography" 121 : 449-450, 2008

      9 Brody AS, "Radiation risk to children from computed tomography" 120 : 677-682, 2007

      10 Boutis K, "Radiation exposure from imaging tests in pediatric emergency medicine: a survey of physician knowledge and risk disclosure practices" 47 : 36-44, 2014

      11 Journy N, "Predicted cancer risks induced by computed tomography examinations during childhood, by a quantitative risk assessment approach" 53 : 39-54, 2014

      12 Leeson K, "Pediatric ultrasound: applications in the emergency department" 31 : 809-829, 2013

      13 Almohiy H, "Paediatric computed tomography radiation dose: a review of the global dilemma" 6 : 1-6, 2014

      14 Kocher KE, "National trends in use of computed tomography in the emergency department" 58 : 452-462, 2011

      15 Morton RP, "Low-dose head computed tomography in children: a single institutional experience in pediatric radiation risk reduction: clinical article" 12 : 406-410, 2013

      16 Broder J, "Increasing utilization of computed tomography in the pediatric emergency department, 2000-2006" 14 : 227-232, 2007

      17 Coco AS, "Increased emergency department computed tomography use for common chest symptoms without clear patient benefits" 25 : 33-41, 2012

      18 Holmes JF, "Identifying children at very low risk of clinically important blunt abdominal injuries" 62 : 107-116, 2013

      19 Kuppermann N, "Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study" 374 : 1160-1170, 2009

      20 Brenner D, "Estimated risks of radiation-induced fatal cancer from pediatric CT" 176 : 289-296, 2001

      21 Le J, "Do clinical outcomes suffer during transition to an ultrasound-first paradigm for the evaluation of acute appendicitis in children?" 201 : 1348-1352, 2013

      22 Brenner DJ, "Computed tomography: an increasing source of radiation exposure" 357 : 2277-2284, 2007

      23 Fahimi J, "Computed tomography use among children presenting to emergency departments with abdominal pain" 130 : e1069-e1075, 2012

      24 Mathews JD, "Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians" 346 : f2360-, 2013

      25 Ahn S, "Advanced radiology utilization in a tertiary care emergency department from 2001 to 2010" 9 : e112650-, 2014

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      연월일 이력구분 이력상세 등재구분
      2027 평가예정 재인증평가 신청대상 (재인증)
      2021-01-01 평가 등재학술지 유지 (재인증) KCI등재
      2020-05-08 학회명변경 영문명 : The Korean Society Of Emergency Medicine -> The Korean Society of Emergency Medicine KCI등재
      2018-01-01 평가 등재학술지 선정 (계속평가) KCI등재
      2016-01-01 평가 등재후보학술지 선정 (신규평가) KCI등재후보
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