克罗恩病患者在急诊室的计算机断层扫描频率

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Hannah W F Goodrich¹, Firrah Saeed², Neal D Dharmadhikari³

¹Section of Digestive Diseases, Yale School of Medicine, New Haven, CT, United States.

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概括

克罗恩氏病患者在急诊室 (ED) 经常接受计算机断层扫描 (CT) 扫描,导致显著的辐射暴露. 医疗保健的障碍与这些患者的ED访问和成像发现的增加有关.

科学领域:

胃肠病学胃肠病学
放射学放射学是一门学科.
公共卫生公共卫生

背景情况:

克罗恩氏病 (CD) 患者经常需要计算机断层扫描 (CT) 扫描在急诊室 (ED).
早期诊断和频繁的急救诊所访问导致CD患者的大量累积辐射暴露.
这种累积辐射构成长期恶性瘤风险的增加.

研究的目的:

评估克罗恩病患者在ED中CT扫描的频率.
为了确定这一群体中CT扫描中的紧急发现率.
为了确定与多个CT扫描相关的患者特征和紧急或负面CT发现的预测因素.

主要方法:

在四个胃肠病诊所和三家医院对660名被诊断为克罗恩氏病患者进行了回顾性研究.
分析了2015年4月至2018年12月期间发生的2473起遭遇事件.
将患者数据与放射学数据库进行交叉引用,以识别1778个执行的CT扫描并分析发现和人口统计数据.

主要成果:

在72%的患者接触中,CT扫描进行.
观察到扫描的偏分布:41%进行了1次扫描,43%进行了2-4次扫描,16%进行了5次以上扫描 (最大24次).
紧急发现 (阻塞,穿孔,) 在28.5%的CT扫描中存在;有医疗障碍的患者显示ED访问和成像发现增加.

结论:

克罗恩氏病患者的辐射暴露率高于一般人群,原因是频繁的急性EDCT扫描.
紧急CT发现的预测因素没有可靠地确定,显著的比例的扫描显示紧急情况.
在多次CT扫描和克罗恩病患者获得医疗保健的障碍之间发现了相关性.

关键词:

克罗恩氏病是什么克罗恩氏病是什么对成像方式的过度利用.健康的社会决定因素

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