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

Islam, Saleem; Abru, Amir Fattah; Obaidani, Saeed Al; Shabibi, Saud Al; Farsi, Sami Al

doi:10.5001/omj.2016.72

Cited by 6 publications

(5 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this survey, the frequency of the rate of abnormal findings in abdominal and pelvic scan was 10.46%, whereas it was 7.32 to 19.9% (24,25) in other studies. One of the most requested abdominal pelvic CT scan is for appendicitis.…”

Section: Discussioncontrasting

confidence: 64%

“…In comparison to other studies, if we added paranasal sinuses scans, the ratio of head and neck scans would be 54.9%; whereas, in other studies, it was 60.1 to 83.64% (23)(24)(25). Although we did not count the brain CT scans requested for head trauma, because our hospital did not admitted traumatic patient, this survey showed another region of requested scans were higher than these studies..…”

Section: Discussionmentioning

confidence: 61%

See 1 more Smart Citation

Reasons for Requesting a CT Scan and Amount of Radiation Exposure in Hospitalized Children, the Issue Needs Attention

et al. 2021

View full text Add to dashboard Cite

Background: Computerized Tomographic (CT) scan is a rapid, non-invasive, and common diagnostic modality in radiology. More and faster growth of cells, as well as longer lifespan of a child, may lead to a cumulative effect of radiation and a greater chance of mutation, especially in children who are more vulnerable. Objectives: This study was designed to evaluate the current trend in the use of this modality. Methods: In this descriptive study, all cases of children admitted to Taleghani Hospital who were studied by CT scan during the years 2018 - 2019, entered in survey. Demographic information, anatomical location of the scan, findings from the CT scan report, initial and final diagnosis, number of scans, patient’s complaint that led to his hospitalization and total amount of radiation received by the patient were analyzed. The data were analyzed by SPSS software version 23 with descriptive statistics (frequency, frequency percentage, and mean and standard deviation). Results: In this study, 344 scans of 280 patients were reviewed. Out of 280 patients, 222 patients underwent scan from one, 55 patients from two and four patients from three different anatomical locations. There were 146 male patients (52.1%) with a mean age of 57.7 months and 134 female patients (47.9%) with a mean age of 54.7 months. Out of all scans, the brain was reported with 45%, chest 30%, and other areas 25%. The CT scan was performed at the request of the doctor in charge. Pneumonia (19%) followed by convulsion (17%) and febrile seizures (12%) were the most common complaints. The number of completely normal CT was 151 scans (44.02%), with brain scans having the highest rate of normal scans with 74.19%. Brain scans with an average of 358.66 milliGray.centimeter (mGy.cm) and a maximum of 995.30 mG/cm had the highest average absorbed dose. Conclusions: In this study, the rate of normal CT scans was relatively high and the range of rays available for each modality was significantly wide. Effective interventions must be made in this regard.

show abstract

Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 61%

Reasons for Requesting a CT Scan and Amount of Radiation Exposure in Hospitalized Children, the Issue Needs Attention

et al. 2021

View full text Add to dashboard Cite

show abstract

“…21 The use of CT scanning also adds to the costs of healthcare. 22 'Mild head injury' patients are, according to the Head Injury Severity Scale classification, initially conscious at first assessment (GCS score [14][15], may have had a brief loss of consciousness or amnesia, but do not have any focal neurological deficits on admission. 23 In mild head-injured children ultrasound might be utilised as a diagnostic tool for identifying skull fracture in children that may otherwise undergo a head CT. [24][25][26] POCUS has become an integral part of emergency medicine practice.…”

Section: Systematic Reviewmentioning

confidence: 99%

Evidence base for point-of-care ultrasound (POCUS) for diagnosis of skull fractures in children: a systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

BackgroundBlunt head trauma is a common presentation to emergency departments (EDs). Identifying skull fractures in children is important as they are known factor of risk for traumatic brain injury (TBI). Currently, CT is the reference standard for diagnosing skull fractures and TBIs in children. Identifying skull fractures with point-of-care ultrasound (POCUS) may help risk-stratify children for TBI following blunt trauma. The purpose of this study is to evaluate the sensitivity, specificity, positive predictive value and negative predictive value of POCUS in identifying skull fractures in children.MethodsA systematic search was performed on 17 July 2020 in Ovid Medline, Cochrane Library, Google Scholar, Web of Science and Embase. Prospective studies reporting skull fractures diagnosed with ultrasound in children younger than 18 years due to blunt head injury were included. Studies that did not confirm the fracture with CT were excluded. The quality of studies was evaluated using the QUADAS-2 tool. Data were extracted from the eligible studies to calculate outcomes such as sensitivity and specificity; when possible overall outcomes were calculated.ResultsSeven studies were included. All eligible studies included patients for whom the decision to perform a CT scan was made in advance. Overall, the included studies demonstrated low risk of bias or had minor concerns regarding risk of bias. The pooled data (n=925) demonstrated a sensitivity of 91%, specificity of 96%, positive predictive value of 88% and negative predictive value of 97%.ConclusionThe included studies demonstrate minor methodological limitations. Overall, the evidence suggests that POCUS is a valid option for diagnosing skull fractures in children visiting the ED after blunt head injury.

show abstract

“…Evidence from almost all conditions suggests that exposure to ionizing radiation during childhood and adolescence is particularly dangerous with respect to increased risk for breast cancer later in life [ 75 , 120 , 121 , 126 ] and that there is a significant dose-response relationship between the dosage of childhood radiation and the increased incidence of breast cancer (trend p < .001) [ 798 ]. Importantly, use of radiation in pediatric medicine leads to higher effective dose for children than for adults given the equivalent radiation exposure, a reflection of their smaller body sizes [ 799 , 800 ].…”

Section: Evidence Linking Environmental Factors and Breast Cancermentioning

confidence: 99%

State of the evidence 2017: an update on the connection between breast cancer and the environment

et al. 2017

View full text Add to dashboard Cite

BackgroundIn this review, we examine the continually expanding and increasingly compelling data linking radiation and various chemicals in our environment to the current high incidence of breast cancer.AbstractSingly and in combination, these toxicants may have contributed significantly to the increasing rates of breast cancer observed over the past several decades. Exposures early in development from gestation through adolescence and early adulthood are particularly of concern as they re-shape the program of genetic, epigenetic and physiological processes in the developing mammary system, leading to an increased risk for developing breast cancer. In the 8 years since we last published a comprehensive review of the relevant literature, hundreds of new papers have appeared supporting this link, and in this update, the evidence on this topic is more extensive and of better quality than that previously available.ConclusionIncreasing evidence from epidemiological studies, as well as a better understanding of mechanisms linking toxicants with development of breast cancer, all reinforce the conclusion that exposures to these substances – many of which are found in common, everyday products and byproducts – may lead to increased risk of developing breast cancer. Moving forward, attention to methodological limitations, especially in relevant epidemiological and animal models, will need to be addressed to allow clearer and more direct connections to be evaluated.

show abstract

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

Abstract: 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.

Cited by 6 publications

References 28 publications

Reasons for Requesting a CT Scan and Amount of Radiation Exposure in Hospitalized Children, the Issue Needs Attention

Reasons for Requesting a CT Scan and Amount of Radiation Exposure in Hospitalized Children, the Issue Needs Attention

Evidence base for point-of-care ultrasound (POCUS) for diagnosis of skull fractures in children: a systematic review and meta-analysis

State of the evidence 2017: an update on the connection between breast cancer and the environment

Contact Info

Product

Resources

About