P. García García , L. del Campo del Val , I. Salmerón Béliz , E. Paz Calzada , C. Alonso Rodríguez , P. García Castañón , P. Rodríguez Carnero
{"title":"分析一家三甲医院急诊科的腹部平片:使用、实用性、解释、放射防护和成本。","authors":"P. García García , L. del Campo del Val , I. Salmerón Béliz , E. Paz Calzada , C. Alonso Rodríguez , P. García Castañón , P. Rodríguez Carnero","doi":"10.1016/j.rx.2023.01.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>The use of abdominal radiography (AXR) apparently continues to be widespread despite its limited indications, the potential radiation and unnecessary costs associated. In addition, the interpretation and its report seem variable and not always performed by a radiologist. Our objective is to analyze the use, adequacy and usefulness of AXR in the emergency of a tertiary referral hospital.</p></div><div><h3>Material and methods</h3><p>We retrospectively reviewed all the AXR performed in January 2020 in the emergency of our centre, as well as the patient's demographics and medical records, technical quality of the radiographs, indications according to the SERAM (Spanish Society of Radiology) Appropriateness Guidelines, presence of a formal radiology report, and impact on the clinical management of the patient. Of all non-appropriated AXR we calculated the radiation received by the patients and its extra costs.</p></div><div><h3>Results</h3><p>In January 2020, 429 AXR (9.1% of all radiographies) were performed in the emergency of our centre. The most frequent indication was abdominal pain (40%, n<!--> <!-->=<!--> <!-->176), followed by low back pain (21.4%, n<!--> <!-->=<!--> <!-->92). 12.4% of AXR requested did not include any clinical information. Most of the AXR (79.6%) had sufficient technical quality. 61.3% (n<!--> <!-->=<!--> <!-->263) of the AXR performed were not indicated, assuming an average unjustified radiation dose per patient of 0.50 ±<!--> <!-->0.33<!--> <!-->mSv, and a total additional cost of 6,575€. Only 6% of the inadequate AXRs led to a change in the clinical management of the patient, compared to 29% of the adequate AXR (<em>P</em> <!--><<!--> <!-->.001). Only 3% of the AXR had a formal radiology report.</p></div><div><h3>Conclusions</h3><p>AXR is still common in the emergency setting, although most of them might be inadequate according to the SERAM Appropriateness Guidelines. Its use should be optimized to avoid unnecessary radiation and costs. Radiologists must have a more active participation in the management of AXR.</p></div>","PeriodicalId":31509,"journal":{"name":"RADIOLOGIA","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Análisis de la radiografía simple de abdomen en la urgencia de un hospital de tercer nivel: uso, utilidad, interpretación, protección radiológica y costes\",\"authors\":\"P. García García , L. del Campo del Val , I. Salmerón Béliz , E. Paz Calzada , C. Alonso Rodríguez , P. García Castañón , P. Rodríguez Carnero\",\"doi\":\"10.1016/j.rx.2023.01.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>The use of abdominal radiography (AXR) apparently continues to be widespread despite its limited indications, the potential radiation and unnecessary costs associated. In addition, the interpretation and its report seem variable and not always performed by a radiologist. Our objective is to analyze the use, adequacy and usefulness of AXR in the emergency of a tertiary referral hospital.</p></div><div><h3>Material and methods</h3><p>We retrospectively reviewed all the AXR performed in January 2020 in the emergency of our centre, as well as the patient's demographics and medical records, technical quality of the radiographs, indications according to the SERAM (Spanish Society of Radiology) Appropriateness Guidelines, presence of a formal radiology report, and impact on the clinical management of the patient. Of all non-appropriated AXR we calculated the radiation received by the patients and its extra costs.</p></div><div><h3>Results</h3><p>In January 2020, 429 AXR (9.1% of all radiographies) were performed in the emergency of our centre. The most frequent indication was abdominal pain (40%, n<!--> <!-->=<!--> <!-->176), followed by low back pain (21.4%, n<!--> <!-->=<!--> <!-->92). 12.4% of AXR requested did not include any clinical information. Most of the AXR (79.6%) had sufficient technical quality. 61.3% (n<!--> <!-->=<!--> <!-->263) of the AXR performed were not indicated, assuming an average unjustified radiation dose per patient of 0.50 ±<!--> <!-->0.33<!--> <!-->mSv, and a total additional cost of 6,575€. Only 6% of the inadequate AXRs led to a change in the clinical management of the patient, compared to 29% of the adequate AXR (<em>P</em> <!--><<!--> <!-->.001). Only 3% of the AXR had a formal radiology report.</p></div><div><h3>Conclusions</h3><p>AXR is still common in the emergency setting, although most of them might be inadequate according to the SERAM Appropriateness Guidelines. Its use should be optimized to avoid unnecessary radiation and costs. Radiologists must have a more active participation in the management of AXR.</p></div>\",\"PeriodicalId\":31509,\"journal\":{\"name\":\"RADIOLOGIA\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"RADIOLOGIA\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S003383382300019X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"RADIOLOGIA","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S003383382300019X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Análisis de la radiografía simple de abdomen en la urgencia de un hospital de tercer nivel: uso, utilidad, interpretación, protección radiológica y costes
Introduction
The use of abdominal radiography (AXR) apparently continues to be widespread despite its limited indications, the potential radiation and unnecessary costs associated. In addition, the interpretation and its report seem variable and not always performed by a radiologist. Our objective is to analyze the use, adequacy and usefulness of AXR in the emergency of a tertiary referral hospital.
Material and methods
We retrospectively reviewed all the AXR performed in January 2020 in the emergency of our centre, as well as the patient's demographics and medical records, technical quality of the radiographs, indications according to the SERAM (Spanish Society of Radiology) Appropriateness Guidelines, presence of a formal radiology report, and impact on the clinical management of the patient. Of all non-appropriated AXR we calculated the radiation received by the patients and its extra costs.
Results
In January 2020, 429 AXR (9.1% of all radiographies) were performed in the emergency of our centre. The most frequent indication was abdominal pain (40%, n = 176), followed by low back pain (21.4%, n = 92). 12.4% of AXR requested did not include any clinical information. Most of the AXR (79.6%) had sufficient technical quality. 61.3% (n = 263) of the AXR performed were not indicated, assuming an average unjustified radiation dose per patient of 0.50 ± 0.33 mSv, and a total additional cost of 6,575€. Only 6% of the inadequate AXRs led to a change in the clinical management of the patient, compared to 29% of the adequate AXR (P < .001). Only 3% of the AXR had a formal radiology report.
Conclusions
AXR is still common in the emergency setting, although most of them might be inadequate according to the SERAM Appropriateness Guidelines. Its use should be optimized to avoid unnecessary radiation and costs. Radiologists must have a more active participation in the management of AXR.
RADIOLOGIARADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
1.60
自引率
7.70%
发文量
105
审稿时长
52 days
期刊介绍:
La mejor revista para conocer de primera mano los originales más relevantes en la especialidad y las revisiones, casos y notas clínicas de mayor interés profesional. Además es la Publicación Oficial de la Sociedad Española de Radiología Médica.