Can lab data be used to reduce abdominal computed tomography (CT) usage in young adults presenting to the emergency department with nontraumatic abdominal pain?

Emergency Radiology

Volumn 17, Issue 5, 2010, Pages 353-360

  Scheinfeld, Meir H ^a   Mahadevia, Soham ^a   Stein, Evan G ^a   Freeman, Katherine ^a   Rozenblit, Alla M ^a  

^a ALBERT EINSTEIN COLLEGE OF MEDICINE   (United States)

Author keywords

Abdominal pain; CT; Emergency department; Laboratory data; Nontraumatic

Indexed keywords

ALKALINE PHOSPHATASE;

ABDOMINAL PAIN; ACUTE APPENDICITIS; ACUTE CHOLECYSTITIS; ADULT; ARTICLE; COLITIS; COMPUTER ASSISTED TOMOGRAPHY; CONTROLLED STUDY; CROHN DISEASE; DIAGNOSTIC VALUE; DIVERTICULITIS; EMERGENCY WARD; FEMALE; GRANULOCYTE; HEMATOCRIT; HEMATURIA; HUMAN; LABORATORY TEST; MAJOR CLINICAL STUDY; MALE; OVARY CYST; PANNICULITIS; PREDICTION; PRIORITY JOURNAL;

ABDOMINAL PAIN; ADULT; BLOOD CHEMICAL ANALYSIS; DATABASES AS TOPIC; EMERGENCY SERVICE, HOSPITAL; FEMALE; HUMANS; INTESTINAL DISEASES; MALE; MIDDLE AGED; MULTIVARIATE ANALYSIS; TOMOGRAPHY, X-RAY COMPUTED;

EID: 77955655459     PISSN: 10703004     EISSN: None     Source Type: Journal    
DOI: 10.1007/s10140-010-0866-y     Document Type: Article

References (36)

1. Grant TH, Rosen MP, Fidler JL, et al (2008) ACR appropriateness criteria. http://www.acr.org/SecondaryMainMenuCategories/quality-safety/app-criteria/pdf/ ExpertPanelonGastrointestinalImaging/ AcuteAbdominalPainandFeverorSuspectedAbdominalAbscessDoc1.aspx. Accessed online 11 February 2010
2. RT Gerhardt BK Nelson S Keenan L Kernan A MacKersie MS Lane 2005 Derivation of a clinical guideline for the assessment of nonspecific abdominal pain: the Guideline for Abdominal Pain in the ED Setting (GAPEDS) Phase 1 Study Am J Emerg Med 23 709 717 10.1016/j.ajem.2005.01.010 16182976 (Pubitemid 41354936)
3. EJ Gallagher, et al. 2000 Clinical policy: critical issues for the initial evaluation and management of patients presenting with a chief complaint of nontraumatic acute abdominal pain Ann Emerg Med 36 406 415 10.1067/mem.2000.109446
4. J Broder DM Warshauer 2006 Increasing utilization of computed tomography in the adult emergency department, 2000-2005 Emerg Radiol 13 25 30 10.1007/s10140-006-0493-9 16900352 (Pubitemid 44440432)
5. DJ Brenner EJ Hall 2007 Computed tomography-an increasing source of radiation exposure N Engl J Med 357 2277 2284 10.1056/NEJMra072149 1:CAS:528:DC%2BD2sXhsVSlurfF 18046031 (Pubitemid 350190758)
6. AC Fleischer AE James Jr JB Millis C Julian 1978 Differential diagnosis of pelvic masses by gray scale sonography AJR Am J Roentgenol 131 469 476 1:STN:280:DyaE1c3ltlylsw%3D%3D 98992
7. JM Boone JA Brunberg 2008 Computed tomography use in a tertiary care university hospital J Am Coll Radiol 5 132 138 10.1016/j.jacr.2007.07.008 18242530 (Pubitemid 351173900)
8. KH Lee YH Kim S Hahn KW Lee HJ Lee TJ Kim SB Kang JH Shin BJ Park 2006 Added value of coronal reformations for duty radiologists and for referring physicians or surgeons in the CT diagnosis of acute appendicitis Korean J Radiol 7 87 96 10.3348/kjr.2006.7.2.87 16799269 (Pubitemid 43953335)
9. MO Philipp K Kubin M Hörmann VM Metz 2003 Radiological emergency room management with emphasis on multidetector-row CT Eur J Radiol 48 2 4 10.1016/S0720-048X(03)00206-7 1:STN:280:DC%2BD3svltVSlsA%3D%3D 14511855 (Pubitemid 37162848)
10. LA Miller K Shanmuganathan 2005 Multidetector CT evaluation of abdominal trauma Radiol Clin North Am 43 1079 1095 10.1016/j.rcl.2005.08.007 16253663 (Pubitemid 41505386)
11. R Kaewlai LL Avery AV Asrani RA Novelline 2008 Multidetector CT of blunt thoracic trauma Radiographics 28 1555 1570 10.1148/rg.286085510 18936021
12. JT Nagurney DF Brown Y Chang S Sane AC Wang JB Weiner 2003 Use of diagnostic testing in the emergency department for patients presenting with non-traumatic abdominal pain J Emerg Med 25 363 371 10.1016/S0736-4679(03)00237- 3 14654174 (Pubitemid 37488039)
13. MP Rosen DZ Sands HE Longmaid 3rd KF Reynolds M Wagner V Raptopoulos 2000 Impact of abdominal CT on the management of patients presenting to the emergency department with acute abdominal pain AJR Am J Roentgenol 174 1391 1396 1:STN:280:DC%2BD3c3kvVKlsQ%3D%3D 10789801
14. R Mezrich 2008 Are CT scans carcinogenic? J Am Coll Radiol 5 691 693 10.1016/j.jacr.2007.12.011 18514945 (Pubitemid 351749583)
15. JL Hadley J Agola P Wong 2006 Potential impact of the American College of radiology appropriateness criteria on CT for trauma Am J Roentgenol 186 937 942 10.2214/AJR.05.0041 (Pubitemid 46100191)
16. ES Amis Jr PF Butler KE Applegate SB Birnbaum LF Brateman JM Hevezi FA Mettler RL Morin MJ Pentecost GG Smith KJ Strauss RK Zeman 2007 American College of Radiology. American College of Radiology white paper on radiation dose in medicine J Am Coll Radiol 4 272 284 10.1016/j.jacr.2007.03.002 17467608 (Pubitemid 46671375)
17. JS Parker LF Vukov PC Wollan 1996 Abdominal pain in the elderly: use of temperature and laboratory testing to screen for surgical disease Fam Med 28 193 197 1:STN:280:DyaK2s%2Fls1aisA%3D%3D 8900552
18. LM Lewis AP Klippel RA Bavolek LM Ross TM Scherer GA Banet 2007 Quantifying the usefulness of CT in evaluating seniors with abdominal pain Eur J Radiol 61 290 296 10.1016/j.ejrad.2006.09.014 17085004 (Pubitemid 46110860)
19. MJ Goske KE Applegate J Boylan PF Butler MJ Callahan BD Coley S Farley DP Frush M Hernanz-Schulman D Jaramillo ND Johnson SC Kaste G Morrison KJ Strauss N Tuggle 2008 The image gently campaign: working together to change practice AJR Am J Roentgenol 190 273 274 10.2214/AJR.07.3526 18212208 (Pubitemid 351196594)
20. EJ Hall 2002 Introduction to session I: helical CT and cancer risk Pediatr Radiol 32 225 227 10.1007/s00247-002-0670-2 11956699 (Pubitemid 36075688)
21. DJ Brenner 2002 Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative Pediatr Radiol 32 223 228 10.1007/s00247-002- 0671-1 (Pubitemid 36075689)
22. DB Safran D Pilati E Folz D Oller 2001 Is appendiceal CT scan overused for evaluating patients with right lower quadrant pain? Am J Emerg Med 19 199 203 10.1053/ajem.2001.21721 1:STN:280:DC%2BD3M3ovVChtA%3D%3D 11326344 (Pubitemid 32378660)
23. S Musunuru H Chen LF Rikkers SM Weber 2007 Computed tomography in the diagnosis of acute appendicitis: definitive or detrimental? J Gastrointest Surg 11 1417 1421 10.1007/s11605-007-0268-y 17701439
24. L Modahl SR Digumarthy JT Rhea AK Conn S Saini SI Lee 2006 Emergency department abdominal computed tomography for nontraumatic abdominal pain: optimizing utilization J Am Coll Radiol 3 860 866 10.1016/j.jacr.2006.05.011 17412185 (Pubitemid 44636381)
25. C Roth R Tello K Sutherland T Ptak 2002 Prediction rule for etiology of vague abdominal pain in the emergency room: utility for imaging triage Invest Radiol 37 552 556 10.1097/00004424-200210000-00003 12352163
26. SH Ahn WW Mayo-Smith BL Murphy SE Reinert JJ Cronan 2002 Acute nontraumatic abdominal pain in adult patients: abdominal radiography compared with CT evaluation Radiology 225 159 164 10.1148/radiol.2251011282 12355000
27. FQ Vandermeer JJ Wong-You-Cheong 2009 Imaging of acute pelvic pain Clin Obstet Gynecol 52 2 20 10.1097/GRF.0b013e3181958173 19179858
28. M Karcaaltincaba M Haliloglu E Akpinar D Akata M Ozmen M Ariyurek O Akhan 2007 Multidetector CT and MRI findings in periportal space pathologies Eur J Radiol 61 3 10 10.1016/j.ejrad.2006.11.009 17123763 (Pubitemid 46038031)
29. A Furlan MP Federle DM Yealy TD Averch K Pealer 2008 Nonobstructing renal stones on unenhanced CT: a real cause for renal colic? AJR Am J Roentgenol 190 W125 W127 10.2214/AJR.07.2922 18212194
30. TA Coury LP Sonda JE Lingeman RJ Kahnoski 1988 Treatment of painful caliceal stones Urology 32 119 123 10.1016/0090-4295(88)90311-1 1:STN:280:DyaL1c3ptFWrtw%3D%3D 3400135
31. JH Scott 3rd M Amin JI Harty 1983 Abnormal urinalysis in appendicitis J Urol 129 1015 6854742
32. HL Brensilver MM Kaplan 1975 Significance of elevated liver alkaline phosphatase in serum Gastroenterology 68 1556 1562 1:STN:280: DyaE2M7mvVKgug%3D%3D 1093921
33. JM Shwayder 2008 Pelvic pain, adnexal masses, and ultrasound Semin Reprod Med 26 252 265 10.1055/s-2008-1076144 18504700 (Pubitemid 351770195)
34. DB Larson SB Rader HP Forman LZ Fenton 2007 Informing parents about CT radiation exposure in children: it's OK to tell them AJR Am J Roentgenol 189 271 275 10.2214/AJR.07.2248 17646450 (Pubitemid 47195909)
35. LG Graff 4th D Robinson 2001 Abdominal pain and emergency department evaluation Emerg Med Clin North Am 19 123 136 10.1016/S0733-8627(05)70171-1 11214394
36. OE Onur O Guneysel EE Unluer H Akoglu A Cingi E Onur A Denizbasi 2008 Outpatient follow-up'' or ''Active clinical observation'' in patients with nonspecific abdominal pain in the Emergency Department. A randomized clinical trial Minerva Chir 63 9 15 1:STN:280:DC%2BD1c%2FlslOgtg%3D%3D 18212722