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. 2018 Jan 31;5(1):35-42.
doi: 10.15441/ceem.16.192. eCollection 2018 Mar.

Long-term changes in computed tomography and ultrasound utilization in a pediatric emergency department

Ikwan Chang  1 , Jae Yun Jung  2 , Young Ho Kwak  1 , Do Kyun Kim  1 , Jin Hee Lee  1 , Jin Hee Jung  3 , Hyuksool Kwon  2 , So Hyun Paek  1 , Joong Wan Park  1
Affiliations

Long-term changes in computed tomography and ultrasound utilization in a pediatric emergency department

Ikwan Chang et al. Clin Exp Emerg Med. .

Abstract

Objective: Many studies have proposed reducing unnecessary use of computed tomography (CT), and ongoing studies in pediatric populations are aiming to decrease radiation dosages whenever possible. We aimed to evaluate the long-term changes in the utilization patterns of CT and ultrasound (US) in pediatric emergency departments (PEDs).

Methods: This retrospective study reviewed the electronic medical data of patients who underwent CT and/or US in the PED of a tertiary referral hospital from 2000 to 2014. We compared the changes in utilization patterns of brain and abdominal CT scans in pediatric patients and analyzed changes in abdominal US utilization in the PED.

Results: During the study period, 196,371 patients visited the PED. A total of 12,996 brain and abdominal CT scans and 12,424 abdominal US were performed in the PED. Comparison of CT use in pediatric patients before and after 2007 showed statistically decreasing trends after 2007, expressed as the coefficient values of the differences in groups. The numbers of brain and abdominal CT scans showed a significant decreasing trend in children, except for abdominal CT in adolescents. The abdominal US/CT ratio in the PED showed a statistically significant increase (2.68; 95% confidence interval, 1.87 to 3.49) except for the adolescent group (5.82; 95% confidence interval, -2.06 to 13.69).

Conclusion: Overall, CT use in pediatric patients has decreased since 2007. Pediatric US use has also shown a decreasing trend; however, the abdominal US/CT ratio in pediatric patients showed an increasing trend, except for adolescents.

Keywords: Child; Computed tomography; Diagnostic imaging; Emergency service, hospital.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Number of annual visits and trend in computed tomography (CT) use; 2000 to 2014. This figure shows the number of annual visits and CT use per 1,000 emergency department visits according to age group. The segmented bar chart indicates the number of visits according to age group during the study period, while the line graph shows the CT use rate per 1,000 emergency department visit according to age group.
Fig. 2.
Fig. 2.
Trend in brain, head, and neck computed tomography (CT) use according to age group from 2000 to 2014.
Fig. 3.
Fig. 3.
Trend in abdominal and genitourinary region computed tomography (CT) use according to age group from 2000 to 2014.
Fig. 4.
Fig. 4.
Trend in ultrasound (US) use and ratio compared with computed tomography (CT) use for the abdominal and genitourinary regions according to age group. The segmented bar chart presents the rate of US use per 1,000 ED visits according to age group, while the graph chart shows the ratio of US use compared with CT use for imaging of the abdominal and genitourinary regions per 1,000 ED visits according to age group.
Fig. 5.
Fig. 5.
Proportions of admissions to the wards and intensive care units (ICUs) during the study period.
See this image and copyright information in PMC

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