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- W4386805564 abstract "Overutilization of neuroimaging in the emergency department (ED), especially CTA head and neck (CTAHN) exams, contributes to rising healthcare expenditures, exposes patients to radiation and may result in delays in care. We evaluated the rate of CTAHN overutilization for patients with nonfocal neurologic complaints in the ED and potential association with patient clinical, demographic data, and ED provider type.This was a retrospective, IRB-approved study performed at a single institution spanning a 6-year period. ED patients with non-focal neurologic complaints who had a CTAHN exam with no history of trauma, recent surgery, or intracranial malignancy were included. Each CTAHN exam was categorized into 4 groups (0=negative, 1=chronic findings not related to presentation, 2=non-acute/nonemergent findings or findings which may account for the presentation, and 3 = acute/emergent findings that may account for the presentation). Basic demographic data including patient age, and gender, ordering ED provider type (attending, resident, non-physician practitioner (NPP)) was collected and analyzed using a multiple logistic regression analysis.960 CTAHN exams were reviewed. Mean age was 50 years (standard deviation=18 years) with 63% females and 37% males. Headache was the most frequent presentation (76%). 75% of cases were negative, and 7% of cases had chronic imaging findings not related to ED presentation. 12.5% of cases had non-acute/nonemergent findings possibly related to the presentation and only 5.5% cases had acute/emergent findings related to ED presentation. A significantly greater proportion of CTAHN exams ordered by NPPs followed by ED residents were negative or had no findings related to the patient presentation, and these patients were ultimately discharged to home.82% ED CTAHN exams performed for patients with non-focal neurologic complaints had no actionable findings. These are significantly more likely to be ordered by NPPs and ED residents." @default.
- W4386805564 created "2023-09-17" @default.
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- W4386805564 date "2023-09-01" @default.
- W4386805564 modified "2023-09-26" @default.
- W4386805564 title "Effect of Provider Type on Overutilization of CT Angiograms of the Head and Neck for Patients Presenting to the Emergency Department with Nonfocal Neurologic Symptoms" @default.
- W4386805564 doi "https://doi.org/10.1016/j.jacr.2023.08.042" @default.
- W4386805564 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/37722466" @default.
- W4386805564 hasPublicationYear "2023" @default.
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