Trends in the rates of radiography use and important diagnoses in emergency department patients with abdominal pain.
BACKGROUND
Computed tomography (CT) and ultrasound (US) are used in emergency departments (ED) to aid in the diagnosis of patients with abdominal pain.


OBJECTIVE
To describe trends in CT and US use in United States EDs and determine if higher test use is associated with higher detection rates for intra-abdominal illnesses commonly detected on CT and US and lower hospital admission rates.


METHODS
Retrospective study using the 2001 to 2005 National Hospital Ambulatory Medical Care Survey, a nationally representative sample of ED encounters.


METHODS
ED patients presenting with abdominal pain.


METHODS
Annual rates of and trends in CT and US use, rates of intra-abdominal illnesses, hospital admission rate.


RESULTS
Abdominal pain visits accounted for 38.8 million encounters; 17.8% received a CT and 11.7% received an US. CT use increased from 10.1% in 2001 to 22.5% in 2005 (P < 0.001). US use increased from 11.1% in 2001 to 13.6% in 2005 (P = 0.002). During the same period, detection rates for appendicitis, diverticulitis, and gall bladder disease did not increase and admission rates did not decrease.


CONCLUSIONS
Despite a more than doubling in CT use and increases in US use, there was no increase in detection rates for appendicitis, diverticulitis, and gall bladder disease nor was there a reduction in admissions.
Pines
Jesse M
JM
Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. pinesjes@uphs.upenn.edu
D015746:Abdominal Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D000328:Adult; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D003695:Delivery of Health Care / Q000639:trends; D004238:Diverticulitis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000639:trends*; D004638:Emergency Treatment / Q000639:trends*; D005260:Female; D005705:Gallbladder Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D007348:Insurance, Health / Q000639:trends; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010343:Patient Admission / Q000639:trends; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000639:trends; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000639:trends*; D014463:Ultrasonography / Q000639:trends*; D014481:United States / Q000453:epidemiology; D019564:Unnecessary Procedures / Q000639:trends