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• W2765726965 abstract "SESSION TITLE: Quality Improvement 1 SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: Widespread use of ‘routine’ imaging studies in the hospital setting is concerning. It is a common practice to obtain a routine chest X Ray with each admission, many times without a valid indication. Many such studies require follow up or further clarification, which lead to subjecting the patient to more imaging studies and invasive tests of varying modality. In this retroscpective chart review, we aim to assess the estimated number of chest X-Ray (CXR), Computed Tomographic Scan of chest (CT) performed and resulting ionizing radiation exposure among a random group of patients admitted with respiratory symptoms in our institution. Although the focus of this study was chest imaging and hence patient cohort with respiratory symptoms were selected, we anticipate the trend would be similar in case of head, abdominal or extremity imaging studies among the patients admitted respectively with head, abdominal and extremity symptoms. METHODS: One hundred seventeen hospitalized patients were seen by the teaching Pulmonary Consult service during the months of August and September 2016 and were selected to be the random cohort. Electronic medical records were reviewed and length of hospital stay (LOS), number of total CXR and CT in each patient was recorded. The dose of ionizing radiation was also determined based on hospital radiology department disclosure of radiation per imaging study protocol. RESULTS: One hundred seventeen inpatients underwent a total of 649 chest imaging studies (CXR 85%, CT chest 15%). Average LOS per hospitalization is 10.5 days (Range: 2- 39 days). Average chest imaging per hospital day was 0.44 for CXR and 0.12 for CT chest. The average ionizing radiation exposure per hospital day is 0.044mSv and 0.96mSv respectively for CXR and CT( Measured per study according to Institutional radiation usage protocol). Average rate of CXR/day were 0.02, 0.15 and 0.26 in patients with LOS <3d, <7d and >7d respectively. Similarly, average number of CT/day was 0.01, 0.06, and 0.05 respectively. Patients with LOS > 7d had an average daily radiation dose of 0.026mSV and 0.4mSv from CXR and CT respectively. CONCLUSIONS: Our data clearly shows that in our current hospital practice model, patients admitted with respiratory symptoms get a significantly high number of chest imaging studies and the number of imaging studies increases dramatically with length of stay >3 days. Cumulative radiation dose is significantly higher in patients with LOS >7 d and as expected significantly increased radiation incur from Chest CT. CLINICAL IMPLICATIONS: This data should raise awareness among physicians about excessive use of chest imaging studies in hospitalized patients. This data adds a new dimension to the problems associated with increased hospital LOS i.e. with increasing LOS, number of imaging studies/day increases dramatically which leads to more radiation exposure and potentially increasing number of follow up testing, thus creating a domino effect. Our ongoing studies are trying to assess clinical implication of each imaging study in terms of change in management. DISCLOSURE: The following authors have nothing to disclose: Eman Albaddawi, Zahia Esber, John Wright, Ahmed Khan No Product/Research Disclosure Information" @default.
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• W2765726965 date "2017-10-01" @default.
• W2765726965 modified "2023-09-26" @default.
• W2765726965 title "High Use Rate of Chest Imaging in Hospitalized Patients and Its Dramatic Increase With Length of Stay" @default.
• W2765726965 doi "https://doi.org/10.1016/j.chest.2017.08.600" @default.
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