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Published on: January 27, 2011
Value of emergent pediatric cardiac computed tomographic angiography service: initial experience at a large
Lauren A May1,2, Snehal R More3, Prakash M Masand1
1Edward B. Singleton Department of Pediatric Radiology, Texas Children's Hospital, 6701 Fannin St., Suite 470, Houston, TX, 77030, USA.
Insights
Emergent pediatric cardiac computed tomography (CT) angiography is increasingly used for children, even after hours. This imaging service significantly impacts surgical and medical management decisions for pediatric cardiac conditions.
Area of Science:
- Pediatric Cardiology
- Diagnostic Imaging
- Cardiovascular Health
Background:
- Pediatric cardiac computed tomography (CT) angiography demand is rising due to improved safety and accuracy.
- Increased use of cardiac CT angiography occurs emergently during off-hours and weekends.
- Staffing challenges exist for providing 24/7 pediatric cardiovascular imaging services.
Purpose of the Study:
- To detail a single-center experience with emergent pediatric cardiac CT angiography.
- To analyze the utilization and impact of after-hours pediatric cardiac CT angiography.
Main Methods:
- Retrospective review of pediatric patients undergoing emergent cardiac CT angiography (Jan 2017-Aug 2018).
- Inclusion of congenital heart disease and coronary imaging.
- Data collection on timing, patient demographics, referral, indication, and outcomes (surgery, intervention, management changes).
Main Results:
- 47 emergent pediatric cardiac CT angiography studies were performed.
- 55% were on weekends/holidays, 45% after 5 PM on weekdays.
- 43% of patients required surgery/intervention, 19% had medical management changes based on findings.
Conclusions:
- Emergent pediatric cardiac CT angiography is a valuable diagnostic tool.
- Further multi-institutional studies are needed to standardize protocols and assess outcome impact.
- Findings may inform future hospital staffing for emergent pediatric cardiovascular imaging.
Background:
Demand for pediatric cardiac computed tomography (CT) angiography is increasing due to recent advances that reduce the need for sedation and radiation exposure while enhancing diagnostic accuracy. This has resulted in the increasing use of cardiac CT angiography emergently during weekends and after hours. The unexpected demand for these services can be challenging, as most hospitals are not staffed to provide 24/7 pediatric cardiovascular imaging.
Objective:
To describe a large single-center experience of providing emergent cardiac CT angiography services in children.
Materials And Methods:
We identified all patients who underwent after--hours weekday and weekend emergent cardiac CT angiography between January 2017 and August 2018. Cardiac CT angiography in the settings of congenital heart disease and coronary imaging were included. Data collected included day and time of cardiac CT angiography, patient age, referral unit, indication, surgical history, need for sedation, need for surgery, intervention and/or change in medical management based on the cardiac CT angiography.
Results:
Forty-seven studies were identified, 26 (55%) of which were performed on a weekend or holiday and 21 (45%) after 5 p.m. on a weekday. Based on cardiac CT angiography findings, 20 (43%) patients underwent either surgery or an interventional procedure, and 9 (19%) had a change in medical management. The time between cardiac CT angiography and the related surgery/intervention ranged from 0 to 29 days with a median of 3.5 days.
Conclusion:
Emergent pediatric cardiac CT angiography is a valuable service. Larger multi-institutional studies with standardized referral and utilization patterns are needed to determine if outcomes are affected by this service, which in turn will influence hospital staffing patterns for emergent imaging.
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