接受全膝关节置换术的患者是否过度使用了磁共振成像?

Lekya Mukkamala, Sabina L Schaffer, Matthew G Weber, Jeffrey M Wilde, Adam S Rosen
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引用次数: 0

摘要

导言:随着医疗成本的不断增加,量化临床上没有必要进行核磁共振成像检查的全膝关节置换术(TKA)患者数量非常重要。本研究的目的是确定我院 TKA 患者在就诊前进行不必要 MRI 检查的人数:方法:确定了 869 名接受初级 TKA 的患者。对医疗记录和成像结果进行审查,以确定哪些患者接受了会诊前磁共振成像检查,以及这些检查是必要的还是不必要的:在 869 例 TKA 患者中,177 例(20.4%)在就诊前接受了磁共振成像检查,其中 112 例符合研究纳入标准。在这112例磁共振成像中,18例(20.7%)是在未进行放射成像的情况下完成的,69例(79.3%)是在放射成像显示为中重度关节炎后完成的。总体而言,87 例(10.0%)核磁共振成像被认为是临床上不必要的:结论:转诊医生在咨询骨科医生之前过度使用核磁共振成像。我们医院在一年时间内对 87 名患者进行了不必要的核磁共振成像检查,花费达 20,706 美元。将这一数字推算到每年受关节炎影响的患者人数中,可能是一笔惊人的数字。应制定循证指南,优化医疗服务的利用率。
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Is Magnetic Resonance Imaging Overused Among Patients Undergoing Total Knee Arthroplasty?

Introduction: With increasing healthcare costs, it is important to quantify the number of total knee arthroplasty (TKA) patients who have MRIs that are not considered clinically necessary. The purpose of this study was to determine the number of unnecessary preconsultation MRIs done among TKA patients at our institution.

Methods: Eight hundred and sixty-nine patients who underwent a primary TKA were identified. Review of medical records and imaging results was conducted to determine which patients had received preconsult MRIs and whether they were necessary or unnecessary.

Results: Of the 869 TKA, 177 (20.4%) presented with a preconsultation MRI, of which, 112 met the study inclusion criteria. Of the 112 MRIs, 18 (20.7%) were done without radiographic imaging, and 69 (79.3%) were completed after radiographically evident moderate-to-severe arthritis. Overall, 87 MRIs (10.0%) were deemed clinically unnecessary.

Conclusions: Referring physicians are overusing MRIs before consultation with an orthopaedic surgeon. The 87 patients who had unnecessary MRIs at our institution over a one-year period represented a cost of $20,706. Extrapolating that number to the scale of patients affected by arthritis each year is potentially a staggering amount of money. Evidence-based guidelines should be put into place to optimize healthcare utilization.

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来源期刊
CiteScore
2.60
自引率
6.70%
发文量
282
审稿时长
8 weeks
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