Maria Isabel Opper Hernando, Denis Witham, Ann-Christine Stahl, Peter Richard Steinhagen, Stefan Angermair, Wolfgang Bauer, Friederike Compton, Andreas Edel, Jan Matthias Kruse, York Kühnle, Gunnar Lachmann, Susanne Marz, Holger Müller-Redetzky, Jens Nee, Oliver Paul, Damaris Praeger, Carsten Skurk, Miriam Stegemann, Alexander Uhrig, Stefan Wolf, Myrto Bolanaki, Kerstin Rubarth, Joachim Seybold, Elke Zimmermann, Marc Dewey, Julian Pohlan
{"title":"对计算机断层扫描指征的批判性反思：脓毒症患者风险和获益管理的跨学科调查。","authors":"Maria Isabel Opper Hernando, Denis Witham, Ann-Christine Stahl, Peter Richard Steinhagen, Stefan Angermair, Wolfgang Bauer, Friederike Compton, Andreas Edel, Jan Matthias Kruse, York Kühnle, Gunnar Lachmann, Susanne Marz, Holger Müller-Redetzky, Jens Nee, Oliver Paul, Damaris Praeger, Carsten Skurk, Miriam Stegemann, Alexander Uhrig, Stefan Wolf, Myrto Bolanaki, Kerstin Rubarth, Joachim Seybold, Elke Zimmermann, Marc Dewey, Julian Pohlan","doi":"10.1186/s13244-024-01894-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To survey physicians' views on the risks and benefits of computed tomography (CT) in the management of septic patients and indications for and contraindications to contrast media use in searching for septic foci.</p><p><strong>Methods: </strong>A web-based questionnaire was administered to physicians at a large European university medical center in January 2022. A total of 371 questionnaires met the inclusion criteria and were analyzed with physicians' work experience, workplace, and medical specialty as independent variables. Chi-square tests were used for exploratory analysis.</p><p><strong>Results: </strong>While physicians with all levels of work experience were included, the largest group (35.0%, n = 130/371) had 3-7 years of experience. Most physicians agreed that the benefits of CT outweigh its potential adverse effects in septic patients (90.5%, n = 336/371). Responders saw the strongest indication for contrast media administration in septic patients for (1) CT examinations of the abdomen (92.7%, n = 333/359) and (2) combined CT examinations of the chest, abdomen, and pelvis (94.1%, n = 337/358). While radiologists were most likely to consider manifest hyperthyroidism an absolute contraindication to contrast media administration (43.8%, n = 14/32), most other groups of physicians opted for appropriate preparation before contrast media administration in this subset of septic patients.</p><p><strong>Conclusion: </strong>In this survey, most participating physicians considered CT an essential diagnostic modality to detect an infectious focus in septic patients. Whereas the risk of ionizing radiation was regarded as justifiable by most physicians, different specialties varied in their assessment of the risks of contrast media administration.</p><p><strong>Key points: </strong>Physicians recognize CT as a relevant imaging modality in the diagnostic management of patients with sepsis. There is an interdisciplinary consensus that the use of ionizing radiation is justified in septic patients. There is disagreement about indications for and contraindications to contrast media administration among physicians from different medical specialties.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"15"},"PeriodicalIF":4.1000,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730041/pdf/","citationCount":"0","resultStr":"{\"title\":\"Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsis.\",\"authors\":\"Maria Isabel Opper Hernando, Denis Witham, Ann-Christine Stahl, Peter Richard Steinhagen, Stefan Angermair, Wolfgang Bauer, Friederike Compton, Andreas Edel, Jan Matthias Kruse, York Kühnle, Gunnar Lachmann, Susanne Marz, Holger Müller-Redetzky, Jens Nee, Oliver Paul, Damaris Praeger, Carsten Skurk, Miriam Stegemann, Alexander Uhrig, Stefan Wolf, Myrto Bolanaki, Kerstin Rubarth, Joachim Seybold, Elke Zimmermann, Marc Dewey, Julian Pohlan\",\"doi\":\"10.1186/s13244-024-01894-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To survey physicians' views on the risks and benefits of computed tomography (CT) in the management of septic patients and indications for and contraindications to contrast media use in searching for septic foci.</p><p><strong>Methods: </strong>A web-based questionnaire was administered to physicians at a large European university medical center in January 2022. A total of 371 questionnaires met the inclusion criteria and were analyzed with physicians' work experience, workplace, and medical specialty as independent variables. Chi-square tests were used for exploratory analysis.</p><p><strong>Results: </strong>While physicians with all levels of work experience were included, the largest group (35.0%, n = 130/371) had 3-7 years of experience. Most physicians agreed that the benefits of CT outweigh its potential adverse effects in septic patients (90.5%, n = 336/371). Responders saw the strongest indication for contrast media administration in septic patients for (1) CT examinations of the abdomen (92.7%, n = 333/359) and (2) combined CT examinations of the chest, abdomen, and pelvis (94.1%, n = 337/358). While radiologists were most likely to consider manifest hyperthyroidism an absolute contraindication to contrast media administration (43.8%, n = 14/32), most other groups of physicians opted for appropriate preparation before contrast media administration in this subset of septic patients.</p><p><strong>Conclusion: </strong>In this survey, most participating physicians considered CT an essential diagnostic modality to detect an infectious focus in septic patients. Whereas the risk of ionizing radiation was regarded as justifiable by most physicians, different specialties varied in their assessment of the risks of contrast media administration.</p><p><strong>Key points: </strong>Physicians recognize CT as a relevant imaging modality in the diagnostic management of patients with sepsis. There is an interdisciplinary consensus that the use of ionizing radiation is justified in septic patients. 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Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsis.
Objectives: To survey physicians' views on the risks and benefits of computed tomography (CT) in the management of septic patients and indications for and contraindications to contrast media use in searching for septic foci.
Methods: A web-based questionnaire was administered to physicians at a large European university medical center in January 2022. A total of 371 questionnaires met the inclusion criteria and were analyzed with physicians' work experience, workplace, and medical specialty as independent variables. Chi-square tests were used for exploratory analysis.
Results: While physicians with all levels of work experience were included, the largest group (35.0%, n = 130/371) had 3-7 years of experience. Most physicians agreed that the benefits of CT outweigh its potential adverse effects in septic patients (90.5%, n = 336/371). Responders saw the strongest indication for contrast media administration in septic patients for (1) CT examinations of the abdomen (92.7%, n = 333/359) and (2) combined CT examinations of the chest, abdomen, and pelvis (94.1%, n = 337/358). While radiologists were most likely to consider manifest hyperthyroidism an absolute contraindication to contrast media administration (43.8%, n = 14/32), most other groups of physicians opted for appropriate preparation before contrast media administration in this subset of septic patients.
Conclusion: In this survey, most participating physicians considered CT an essential diagnostic modality to detect an infectious focus in septic patients. Whereas the risk of ionizing radiation was regarded as justifiable by most physicians, different specialties varied in their assessment of the risks of contrast media administration.
Key points: Physicians recognize CT as a relevant imaging modality in the diagnostic management of patients with sepsis. There is an interdisciplinary consensus that the use of ionizing radiation is justified in septic patients. There is disagreement about indications for and contraindications to contrast media administration among physicians from different medical specialties.
期刊介绍：
Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere!
I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe.
Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy.
A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field.
I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly.
The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members.
The journal went open access in 2012, which means that all articles published since then are freely available online.
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