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紧急诊所儿童的低值计算机断层扫描:一项重复的横截面研究
Gabrielle C Freire1,2, Christina Diong3, Sima Gandhi3
1Department of Pediatrics, Division of Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON.
低值的计算机断层扫描 (CT) 在非儿科医院的儿科急诊室 (ED) 和非儿科专家治疗儿童时更为常见. 针对特定的医院类型和医生专业需要有针对性的干预措施.
科学领域:
- 儿童紧急医疗
- 医疗服务研究
- 放射学
背景情况:
- 计算机断层扫描 (CT) 扫描在儿科急诊室经常使用.
- 为了减少某些儿科诊断的低值CT使用,有指导方针.
- 根据医院类型和提供者的专业,CT使用的差异尚不清楚.
研究的目的:
- 为了比较小值计算机断层扫描 (CT) 在儿科急诊室 (ED) 的使用情况.
- 分析基于医院类型和医生专业的CT使用变化.
主要方法:
- 一项重复的横截面研究分析了加拿大安大略省 (2010-2019) 的链接数据库.
- 对五种诊断的儿科ED出院情况进行了审查,并提出了反对常规CT使用的建议.
- 根据患者,ED和医生特征调整的多变量逻辑回归,以根据医院类型和提供者的专业评估CT使用情况.
主要成果:
- 分析了超过599,000例儿童ED出院病例.
- 与儿童学术医院相比,在成人学术和社区医院 (有或没有儿科咨询) 接受CT扫描的几率更高.
- 与儿科急诊医生相比,非儿科医生的患者更有可能接受所有诊断的CT扫描.
结论:
- 在非儿科ED和非儿科提供者治疗的儿童中,低值CT的利用率显著更高.
- 改善措施应集中在特定的医院类型和医生专业, 以减少不必要的CT扫描.
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