Do abnormal liver function tests predict inpatient imaging yield? An evaluation of clinical decision making

Area of Science:

• Hepatology
• Diagnostic Imaging
• Clinical Medicine

Background:

• Abdominal imaging is commonly used in hospitalized patients to investigate abnormal liver function tests (LFTs).
• Predicting the diagnostic yield of these imaging studies based on LFT abnormalities is crucial for efficient patient management.

Purpose of the Study:

• To evaluate if the extent and severity of liver function test abnormalities correlate with the diagnostic yield of inpatient abdominal imaging.
• To determine the predictive value of LFT patterns for positive imaging findings.

Main Methods:

• Retrospective review of 759 inpatient abdominal imaging studies performed for abnormal LFTs over 27 months.
• Matching imaging results with LFTs within a 5-day window.
• Categorizing five LFTs by severity and grouping them into three pathophysiological classes.

Main Results:

• Only 26% of imaging studies were positive (abnormal and explained LFTs).
• Severity of transaminase abnormality showed a correlation with positive yield (18% vs. 31%).
• Extent of LFT abnormalities showed a weak correlation with positive yield (21% vs. 35%).

Conclusions:

• The diagnostic yield of inpatient abdominal imaging for abnormal LFTs has a weak correlation with LFT severity and extent.
• Optimal imaging strategies for hospitalized patients with suspected hepatobiliary disease require further investigation.