[Diagnostic value and therapeutic consequences of computerized tomography (patient outcome research)--1: Diagnosis in...

During three months of 1993, 201 primary traumatologic patients (125 m, 76 f, x = 42.6 years) underwent 230 computed tomography examinations (= one CT of one body region) in the radiologic department of the Rudolf Virchow University Hospital. 87.0% of the CT's were performed completely without contrast media, 2.6% exclusively supported by intravenously given contrast media, 9.1% in both ways, and 1.3% after intra-articular contrast media administration. 97.4% served for primary diagnostic purposes and 2.6% for the control of therapeutic results. In 47.8% of the CT's, the principle diagnosis in the scanned body region was known before CT, i.e. by conventional X-ray examinations, but further detailed information was necessary to clarify the indication for operation and to choose the operative mode. In 52.2%, the diagnosis without CT was impossible by other, non-invasive and not more expensive methods. The CT diagnoses were correctly positive in 58.7% (suspected diagnosis verified, additional detail information...) and correctly negative in 41.3% (suspected diagnosis excluded). 60.9% of CT's demonstrated a missing indication for operation in the examined body region; in 39.1% the operation followed. The most frequently performed diagnostic methods before CT were conventional X-ray and sonography, whereas after CT further examinations were seldom needed. We conclude that traumatologic CT's contribute decisively to the reduction of costs by avoiding more expensive examination methods, avoiding redundant operations, and abridging stay duration in the hospital because of more efficient therapy planning.