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Focused versus screening CT scans for evaluation of nontraumatic abdominal pain
in the emergency department
#MMPMID27147834
Thurston K
; Magge S
; Fuller R
; Voytovich A
; Lee J
; Kozol R
Open Access Emerg Med
2010[]; 2
(?): 25-7
PMID27147834
show ga
OBJECTIVE: To evaluate the utility of computed tomography (CT) scans in patients
with abdominal pain in the emergency department. We compared focused scans
(having a single diagnosis in mind) and screening scans (having no diagnosis or
more than one diagnosis in mind) with the hypothesis that focused scans will
reveal pathology more often than screening scans. Treatment plans and patient
outcomes were also compared between the two populations. METHODS: This is a
prospective study in which 100 patients who presented to an academic medical
center with abdominal pain and underwent an abdominal CT were enrolled in the
study. A chart review was later completed to gather ultimate outcome data for
each of the enrolled subjects. RESULTS: Of the 61 patients having a focused CT,
pathology was identified on 63.9% of the scans, which did not differ
significantly from the 65.4% of scans that revealed pathology in the screening
group. In the focused group, anticipated admissions were reduced, but the
reduction was not significant. The screening group did show a significant
difference, with eight fewer patients being admitted than initially planned. The
total number of patients deemed to require admission was significantly reduced by
15% following all CT scans. CONCLUSION: While there was no difference between the
focused and screening groups in the rate of identifying pathology, there was a
significant decline in number of patients requiring admission to the hospital in
the "screening" CT group (when comparing emergency physicians' pre- and post-CT
treatment plans).