[Medical radiation exposure and justification at a large teaching hospital: comparison of radiation-related and disease-related risks].
OBJECTIVE
The medical X-ray exposure was determined in a 2400-bed hospital. The radiation-related risk was compared with the severity of disease (ICD) to verify the justification for X-ray procedures. A model to estimate radiation and disease-related "loss of lifetime" was applied.


METHODS
X-ray exposure from radiography, fluoroscopy and CT was determined for diagnostic and interventional procedures during one hospital stay of 403 patients (0.5 % of all 80 000 patients/year). CTDI and DLP in CT, DAP in fluoroscopy or SED in radiography were used to calculate the effective dose (ED). The disease and radiation-related risk were compared with a simple "loss of lifetime" model.


RESULTS
The mean age of all patients was 60. Only a subgroup of 170 patients (42 %) with a mean age of 67.6 had one or more X-ray procedures. The average ED of these exposed patients was 5.12 mSv. 14.4 % CT examinations had a dose contribution of 52.5 % followed by 5.3 % radiology and cardiology procedures at 37.2 %. 90 % of ED was applied to only 44 patients (11 %) and 50 % of ED was applied to only 10 patients (2.5 %) with a mean age of 71.2. 4 of these 10 patients had malignant tumors, the other 6 suffered from pulmonary embolism, pneumonia, stent-graft infection, CAD, Crohn's disease and severe hypertension. The ratio of disease vs. radiation-related risk was between 2.1 : 1 and 1800 : 1.


CONCLUSIONS
In this study referral for justified X-ray procedures in a large hospital with high level medical care offers a significant patient benefit.
Loose
R W
RW
Institut für Diagnostische und Interventionelle Radiologie, Klinikum Nürnberg-Nord, Prof.-Ernst-Nathan-Strasse 1, Nürnberg. loose@klinikum-nuernberg.de
Popp
U
U
Wucherer
M
M
Adamus
R
R
D000368:Aged; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects*; D005858:Germany; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000453:epidemiology*; D011859:Radiography / Q000009:adverse effects*; D015641:Radiography, Interventional / Q000009:adverse effects*; D011872:Radiology Department, Hospital; D011874:Radiometry; D018570:Risk Assessment / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed / Q000009:adverse effects*