Is Chest CT Performed Too Often?

DiMarco, Anthony F.; Briones, Berta

doi:10.1378/chest.103.4.985

Cited by 37 publications

(14 citation statements)

References 8 publications

(3 reference statements)

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“…If the superiority of CT to CR for the diagnosis and severity scoring of CAP in the elderly is confirmed, then the radiation risk may be the most important limiting factor for the evaluation of CAP by CT (16,17). The benefit of early antibiotic therapy in patients presenting with severe infections has been recognized (6, 18), and we agree.…”

Section: Discussionmentioning

confidence: 56%

Computed Tomography for the Diagnosis and Evaluation of the Severity of Community-acquired Pneumonia in the Elderly

et al. 2016

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Objective We herein assessed the utility of computed tomography (CT) for the diagnosis and ascertainment of the severity of community-acquired pneumonia (CAP) in the elderly. Methods The utility of CT compared with chest radiography (CR) for the diagnosis of CAP was prospectively studied among elderly inpatients with clinical symptoms and signs indicative of CAP at the Department of Respiratory Medicine in Nissan Tamagawa Hospital during the one-year period from January 2013 to December 2013. Additionally, we evaluated whether the findings of CT were useful as predictive factors related to the mortality rate associated with CAP. Results One hundred and forty-two patients, 65 years of age or older, were surveyed upon hospital admission for suspected CAP. Of the 142 patients included, 127 (89.4%) had pneumonic infiltration diagnosed by CT, however, CR could not recognize pneumonic infiltration in 9.4% (12/127) of these patients. In 127 CAPpositive patients, bilateral pneumonic infiltration was more frequently detected by CT in non-survivors than survivors (79.0% vs. 53.7%; p <0.05). By a multivariable analysis to determine the prognostic factors related to mortality from CAP, oxygen desaturation showed the greatest odds ratio among the other predictive factors, followed by comorbid neoplastic disease, blood urea nitrogen ! 21 mg/dL, male gender, and bilateral pneumonic infiltration diagnosed by CT. Conclusion We herein demonstrated that CT was superior to CR for diagnosing and evaluating the severity of CAP in elderly patients.

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Section: Discussionmentioning

confidence: 56%

Computed Tomography for the Diagnosis and Evaluation of the Severity of Community-acquired Pneumonia in the Elderly

et al. 2016

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“…However, these researchers scarcely assessed physicians' opinions and their level of knowledge of the risks (DiMarco & Briones, 1993;DiMarco & Renston, 1994;Ludwing & Turner, 2002;Renston, Connors, & DiMarco, 1996). Moreover, nurses' opinions regarding this matter were not studied at all.…”

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confidence: 99%

Attitude and Knowledge of Physicians and Nurses About Ionizing Radiation

Rassin

Granat

Berger

et al. 2005

Journal of Radiology Nursing

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“…The debate on the appropriate use of chest CT is mainly in the adult literature but this issue is at least as important in pediatric practice. 2,9 The superior anatomical resolution and decreased superimposition of structures on CT allows better assessment of parenchymal and airway abnormalities than plain radiography. In the investigation of chest disease in adults, high sensitivity and specificity has been found for CT in the diagnosis of bronchiectasis and ILD.…”

Section: Discussionmentioning

confidence: 99%

“…Concern has been raised at the possible overuse of chest CT in adult practice where the issue of sedation does not arise. 9 The number of requests for CT in pediatric patients in our institution has risen from 64 in 1991 to 104 in 1995. Therefore, we prospectively analyzed the results of all our pediatric chest CT scans over 12 months to determine whether our current use of this investigation was appropriate.…”

Section: Introductionmentioning

confidence: 99%