Variable utilization patterns of computed tomography for rhinosinusitis in emergency departments

Area of Science:

• Otolaryngology
• Radiology
• Health Services Research

Background:

• Computed tomography (CT) utilization for rhinosinusitis in emergency departments (EDs) is not well-documented.
• Understanding patterns and predictors of sinus CT scans is crucial for appropriate resource allocation and patient care.

Purpose of the Study:

• To describe the utilization patterns of sinus CT scans in EDs for rhinosinusitis.
• To identify patient-specific, socioeconomic, and geographic factors predicting the use of sinus CT scans.

Main Methods:

• Retrospective review of the Nationwide Emergency Department Sample (2009-2011).
• Analysis of patient encounters with a primary diagnosis of sinusitis (ICD-9 codes 461*, 473*).
• Univariable and multivariable logistic regression to determine factors associated with CT scan use.

Main Results:

• Over 2.2 million sinusitis visits were analyzed; 2.4% received a CT scan.
• Socioeconomic factors (insurance, residence, income) and symptoms (headache, injury history) predicted CT use.
• Male gender and Northeast hospital location were also significant predictors in multivariable analysis.

Conclusions:

• Socioeconomic, demographic, and geographic factors significantly influence sinus CT scan use in the ED for rhinosinusitis.
• Findings suggest potential healthcare utilization disparities and the need for refined CT imaging guidelines in ED settings.