Appropriateness of selection criteria for CT examinations performed at an emergency department

In the diagnosis of traumatic and nontraumatic emergencies, computed tomography (CT) is the most frequently performed procedure. The aims of this study were to find out whether CT report results can be used as a reliable tool for the diagnosis and management of patients at an emergency department and to evaluate the appropriateness of the selection criteria for CT examinations. For this reason, we analysed the emergency CT procedures according to the diagnostic hypothesis written on CT request forms, the results of the CT reports and the final diagnosis of the patients. One thousand consecutive CT procedures in the emergency department of a research hospital were retrospectively analysed. When the CT reports and the final diagnosis were evaluated, the sensitivity and specifity of the CT were found to be 0.81 and 0.85. According to the analysis of the CT reports, 55.8 % of all the patients were reported to be normal. When the patient files were examined for the final diagnosis of the patients, 55.7 % of the patients did not receive a final diagnosis related to the diagnostic hypothesis. The lowest correlation was found between the diagnostic hypothesis, the CT reports and the final diagnosis of the patients who underwent cranial CT procedure for trauma. The results of the CT reports can be used as a reliable parameter for the diagnosis and management of the patients at emergency departments. On the other hand, a high negative rate of CT reports was noted especially for the cranial CT examinations. CT selection criteria for the head trauma patients should be reconsidered. Since CT is a procedure involving ionising radiation, it is important that it is performed with the correct indications and the relevant clinical information is specified on the CT request forms.