[Superfluous computed tomography utilization for the evaluation of the pelvis and spinal column in an orthopedic emergency department].
OBJECTIVE
This study was designed to investigate the frequency of requests for computed tomography (CT) examination of the spinal column and pelvis in our emergency orthopedic department, the reasons of requests, and the rates of positive and negative CT examinations.


METHODS
We retrospectively reviewed patients for whom a request for CT examination was made by the emergency orthopedic department within a year (September 2005- 2006). The reasons for CT requests, findings in CT reports, and age and sex of the patients were recorded. Findings unrelated and related to the original request denoted a negative and positive CT examination, respectively.


RESULTS
Of 24,378 admissions to our emergency orthopedic department, a CT scan was requested in 1,295 patients (5.3%). In 817 patients (63.1%), CT examination involved the pelvis or the spinal column. Of these, 418 CT scans (51.2%) yielded a negative result. The mean age of the patients with a negative CT scan was significantly lower than those having a positive CT scan (40.7 vs 45.1 years; p=0.001). There was no significant difference with respect to sex between patients having negative and positive CT findings (p=0.670). Compared to pelvis CT scans, the frequency of negative CTs was significantly higher for spinal column examinations (p<0.001). The incidence of negative CT scans for upper thoracic and cervical vertebrae was significantly higher than that found for lower thoracic and lumbar regions (p<0.001).


CONCLUSIONS
The high incidence of negative CT scans documented for pelvic and spinal column examinations underlines the need for measures to avoid superfluous CT requests in emergency departments.
Dağlar
Bülent
B
Department of Orthopedics and Traumatology (4. Ortopedi ve Travmatoloji Kliniği), Ankara Numune Training and Research Hospital, Ankara, Turkey. budugul@yahoo.com
Delialioğlu
Onder Murat
OM
Ceyhan
Erman
E
Ozdemir
Güzelali
G
Taşbaş
Bülent Adil
BA
Bayrakci
Kenan
K
Günel
Uğur
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004638:Emergency Treatment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D010388:Pelvis / Q000000981:diagnostic imaging* / Q000293:injuries; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014421:Turkey / Q000453:epidemiology; D019564:Unnecessary Procedures / Q000706:statistics & numerical data