Trends in CT Request and Related Outcomes in a Pediatric Emergency Department

Abstract

Objectives: To study and to establish the overall trends of computed tomography (CT) use and associated outcomes in the pediatric emergency department (PED) at Royal Hospital, Oman, from 2010 to 2014.

Methods: The hospital electronic medical record was retrospectively searched to find children (from birth to 12 years old) who had visited the PED and the number of CT requests between 1 January 2010 and 31 December 2014. The types of CT examinations ordered were analyzed according to anatomical location and were as follows; head, abdomen/pelvis, chest, cervical spine/neck, and others.

Results: There were a total of 67 244 PED visits during the study period, 569 of which received 642 CT scans. There was a remarkable rise in CT uses per 1000 visits from 7 in 2010 to 12 in 2014. There was a 56% hike in CT requests from 87 in 2010 to 175 in 2014 while the number of pediatric emergency visits rose by about 28% from 11 721 to 15 052. Although head CT scans were the most common, cervical spine CT scans had the highest rate of increase (600%) followed by the chest (112%), head (54%) and abdomen (13%). There were no significant changes in other CT scan requests. The cost of CT scans increased from $18 096 to $36 400 during the study period, which increased the average PED cost by about $2 per visit. The average time between a CT being requested and then performed was 1.24 hours.

Conclusions: CT use in the pediatric emergency department has risen significantly at a rate that markedly exceeds the growth of emergency visits. This is associated with an increase in PED costs and longer waiting times.

Keywords: Pediatric Medicine, Computed Tomography; Radiation Exposure..