{"title":"Trends in CT pulmonary angiography utilization and recurrent imaging in sickle cell disease: a longitudinal study.","authors":"Ali Hassan, Najla Alomani, Mawaheb Kalalah, Nawra Mujbel, Zainab Khamdan, Murtadha Alobaydun, Mohammed AlAlmai, Zuhur Alazmi, Abdulelah Musihel, Hamad Qabha, Jalila Adnan","doi":"10.1186/s12245-025-00871-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease (SCD) is a common inherited hemoglobinopathy associated with vaso-occlusive events that can mimic pulmonary embolism (PE), leading to the frequent use of computed tomography pulmonary angiography (CTPA). However, trends in CTPA utilization over time remain unclear. This study aims to evaluate temporal trends and recurrent imaging patterns.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at Salmaniya Medical Complex, Bahrain, including SCD patients who underwent CTPA for suspected PE between April 15, 2013, and April 15, 2024. Descriptive statistics were used to report the frequency of recurrent scans, whereas linear regression analysis was employed to assess trends in CTPA utilization over the study period.</p><p><strong>Results: </strong>The study included 1,084 patients (median age: 35 years, 55.7% male) with SCD who underwent a total of 1,934 CTPA scans. CTPA utilization remained stable from 2014 to 2020, averaging 10.0-13.6 scans per month. However, a significant surge was observed post-2020, coinciding with the COVID-19 pandemic, peaking in 2023, with an average of 31.3 scans per month, indicating a 2.9-fold increase (p = 0.03). During the study period, 415 patients (38.3%) underwent recurrent CTPA scans, with one-third (32.5%, n = 276) of these scans occurring within a 6-month interval. Although the PE positivity rate was lower in recurrent scans than in initial scans, the difference was not statistically significant (8.8% vs. 10.5%; p = 0.22).</p><p><strong>Conclusions: </strong>CTPA utilization among SCD patients remained stable for several years but increased significantly after 2020, coinciding with the COVID-19 pandemic. A substantial proportion of scans were recurrent, with many occurring within a short interval. Moving forward, efforts should focus on mitigating radiation exposure through low-dose protocols and investigating potential factors contributing to the recent increase in scan utilization.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"68"},"PeriodicalIF":2.0000,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963513/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Emergency Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s12245-025-00871-x","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Sickle cell disease (SCD) is a common inherited hemoglobinopathy associated with vaso-occlusive events that can mimic pulmonary embolism (PE), leading to the frequent use of computed tomography pulmonary angiography (CTPA). However, trends in CTPA utilization over time remain unclear. This study aims to evaluate temporal trends and recurrent imaging patterns.
Methods: A retrospective cohort study was conducted at Salmaniya Medical Complex, Bahrain, including SCD patients who underwent CTPA for suspected PE between April 15, 2013, and April 15, 2024. Descriptive statistics were used to report the frequency of recurrent scans, whereas linear regression analysis was employed to assess trends in CTPA utilization over the study period.
Results: The study included 1,084 patients (median age: 35 years, 55.7% male) with SCD who underwent a total of 1,934 CTPA scans. CTPA utilization remained stable from 2014 to 2020, averaging 10.0-13.6 scans per month. However, a significant surge was observed post-2020, coinciding with the COVID-19 pandemic, peaking in 2023, with an average of 31.3 scans per month, indicating a 2.9-fold increase (p = 0.03). During the study period, 415 patients (38.3%) underwent recurrent CTPA scans, with one-third (32.5%, n = 276) of these scans occurring within a 6-month interval. Although the PE positivity rate was lower in recurrent scans than in initial scans, the difference was not statistically significant (8.8% vs. 10.5%; p = 0.22).
Conclusions: CTPA utilization among SCD patients remained stable for several years but increased significantly after 2020, coinciding with the COVID-19 pandemic. A substantial proportion of scans were recurrent, with many occurring within a short interval. Moving forward, efforts should focus on mitigating radiation exposure through low-dose protocols and investigating potential factors contributing to the recent increase in scan utilization.
期刊介绍：
The aim of the journal is to bring to light the various clinical advancements and research developments attained over the world and thus help the specialty forge ahead. It is directed towards physicians and medical personnel undergoing training or working within the field of Emergency Medicine. Medical students who are interested in pursuing a career in Emergency Medicine will also benefit from the journal. This is particularly useful for trainees in countries where the specialty is still in its infancy. Disciplines covered will include interesting clinical cases, the latest evidence-based practice and research developments in Emergency medicine including emergency pediatrics.
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