Chief complaints and computed tomography results in the emergency department: a three-year retrospective cohort study

Area of Science:

• Emergency Medicine
• Radiology
• Clinical Decision Making

Background:

• Computed tomography (CT) is common in emergency department (ED) patients who return within 72 hours.
• The utility of chief complaints in guiding CT use for these patients is unclear.

Purpose of the Study:

• To investigate the association between patient chief complaints and computed tomography (CT) findings in emergency department (ED) revisits.
• To determine if chief complaints effectively predict positive CT results.

Main Methods:

• Retrospective cohort study of adult patients returning to the ED (2019-2021).
• Data collected included demographics, pre-existing conditions, chief complaints, and CT region.
• Logistic regression analysis was used to assess the relationship between chief complaints and positive CT results.

Main Results:

• Of 7,699 revisits, 1,202 (15.6%) had CT scans.
• Abdominal pain and gastrointestinal symptoms were linked to higher positive abdominopelvic CT rates (OR 2.83).
• Central nervous system and cardiopulmonary complaints showed no association or a negative association with new positive CT findings.

Conclusions:

• Patient chief complaints correlate with the diagnostic yield of CT scans in the emergency department (ED) on patient revisits.
• Physicians should leverage chief complaint data to optimize the use of CT imaging for returning ED patients.