title: Radiation exposure from diagnostic imaging studies among patients with inflammatory bowel disease in a safety-net health-care system.
abstract: OBJECTIVE
  Radiographic imaging studies are important in the management of patients with inflammatory bowel disease (IBD), but are associated with radiation exposure. IBD patients in a safety-net health-care system may be at risk of high exposure to radiation. Our purpose was to identify associations of high-dose radiation exposure among an ethnically diverse cohort of IBD patients in a safety-net health-care system.
  
  
  METHODS
  A study was performed on patients with IBD receiving care from the Harris County Hospital District. Radiation exposure was calculated using total number of imaging studies performed between from 2000 and 2010 and estimates of radiation dose per study. Associations of high-dose radiation exposure, defined as a cumulative effective dose (CED) >50 mSv, were identified by using univariate and multivariate logistic regression.
  
  
  RESULTS
  The study cohort of 278 patients with IBD was ethnically diverse, with 30 % Caucasian, 44 % African-American, and 26 % Hispanic. The median CED was 10.40 mSv (SD 20.02). Annualized radiation doses were 3.45 mSv/year among patients with Crohn's disease (CD) and 1.27 mSv/year among patients with ulcerative colitis, p < 0.02. Approximately 13 % of IBD patients received a CED >50 mSv. There were no differences in radiation exposure based on age, gender, or race/ethnicity.
  
  
  CONCLUSIONS
  A small proportion of IBD patients in a safety-net health-care system received high doses of diagnostic radiation exposure. Use of diagnostic imaging studies that limit radiation exposure should be encouraged.
authors.affiliation: Houston VA HSR&D Center of Excellence; Michael E. DeBakey Veterans Affairs Hospital, 1709 Dryden Road, Suite 8.40, MS: BCM 620, Houston, TX, 77030, USA, jkhou@bcm.tmc.edu.
authors.forename: Jason K
authors.initials: JK
authors.lastname: Hou
authors.forename: Hoda M
authors.initials: HM
authors.lastname: Malaty
authors.forename: Selvi
authors.initials: S
authors.lastname: Thirumurthi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003093:Colitis, Ulcerative / Q000000981:diagnostic imaging* / Q000208:ethnology; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000208:ethnology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011829:Radiation Dosage; D011859:Radiography; D012189:Retrospective Studies; D064876:Safety-net Providers; D013781:Texas
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