Prospective audit of cross-sectional imaging and radiation exposure in general surgical patients.
BACKGROUND
Most patients admitted with an acute surgical problem undergo some imaging during their in-patient stay. As computed tomography (CT) scanning becomes more readily available, it is becoming the mainstay of assessment. Recent studies have commented on the potential adverse effects of early cross-sectional imaging. This audit aimed to determine the use of early cross-sectional imaging and associated radiation dose in an acute surgical cohort.


METHODS
Data from 500 acute surgical patients were prospectively collected over a 3-month period. CT scans were undertaken, the effect on subsequent diagnostic and management decisions and the potential associated risks were evaluated.


RESULTS
Almost 40% of subjects underwent CT scanning. Of these, 20% did not alter management and could be deemed unnecessary. The radiation exposure equated to an age- and gender-specific risk of fatal cancer induction between 1 in 1675 and 1 in 7130.


CONCLUSIONS
Early-cross sectional imaging provides a valuable diagnostic adjunct. Decisions to expose patients to potentially hazardous radiation need to acknowledge the anticipated benefits versus risks.
Addenbrooke's Hospital, Cambridge, UK. Rosie1878@doctors.org.uk
R A
RA
Cadwallader
S R
SR
Walsh
B
B
Burrows
C L
CL
Chappell
C
C
Cousins
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000209:etiology* / Q000401:mortality; D011829:Radiation Dosage; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000009:adverse effects*; D055815:Young Adult