Trends in computed tomography utilisation in the emergency department: A 5 year experience in an urban medical centre in northern Taiwan

• Published in: Emergency medicine Australasia Vol. 28; no. 2; pp. 153 - 158
• Main Authors: Chang, Julia Chia-Yu, Lin, Yan-Ying, Hsu, Teh-Fu, Chen, Yen-Chia, How, Chorng-Kuang, Huang, Mu-Shun
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.04.2016
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; computed tomography; emergency department; Emergency Service, Hospital - statistics & numerical data; Female; Hospitals, Urban - statistics & numerical data; Humans; Male; Middle Aged; Retrospective Studies; Taiwan; Tomography, X-Ray Computed - trends; Tomography, X-Ray Computed - utilization; utilisation rate; Young Adult; computed tomography; emergency department; utilisation rate
• ISSN: 1742-6731; 1742-6723
• DOI: 10.1111/1742-6723.12557

Background Steady increase in computed tomography (CT) utilisation in the ED was observed in countries such as the USA, Canada, China and Korea; however, limited empirical data are available regarding Taiwan. Objective The objective of the present study is to quantify and compare trends in CT utilisation in the ED over a 5 year period in a medical centre in Taiwan. Methods Electronic chart review was performed in a medical centre with an annual ED census of 80 000 patients. Subjects >20 years of age who underwent CT scans during ED visits from 1 January 2005 to 31 December 2009 were identified. Results Among the 333 673 adult ED visits, 43 635 received CT scans, with a utilisation rate of 131 per 1000. Within the 5 year span, patient volume increased by 7.7%, whereas CT utilisation increased by 42.7%. The rates of increase in patient volume and CT utilisation were 5.0% and 32.4% in non‐trauma; 19.7% and 97.8% in trauma. CT scans were mostly performed on the head (47%), abdomen (36%), followed by chest (10%) and miscellaneous (7%). An increase of 168% in spinal CTs for trauma patients was observed. An increase in CT utilisation was found in all age groups with a proportionate increase with increasing age in both trauma and non‐trauma. Conclusion ED CT utilisation has increased at a rate far exceeding the growth in ED patient volume. This may be attributed to the improved utility of CT in diagnosing serious pathology, more diagnostic indications for CT, ready availability and the necessity for diagnostic certainty in the ED.