Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital

Utility of multiple rule out CT screening of high-risk atraumatic patients in an emergency department-a feasibility study

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Clinical usefulness of FDG-PET/CT for identification of abnormal extra-cardiac foci in patients with infective endocarditis

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Abnormal routine blood tests as predictors of mortality in acutely admitted patients

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Screening relatives in arrhythmogenic right ventricular cardiomyopathy: yield of imaging and electrical investigations

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: Several large trials have evaluated the effect of CT screening based on specific symptoms, with varying outcomes. Screening of patients with CT based on their prognosis alone has not been examined before. For moderate-to-high risk patients presenting in the emergency department (ED), the potential gain from a CT scan might outweigh the risk of radiation exposure. We hypothesized that an accelerated "multiple rule out" CT screening of moderate-to-high risk patients will detect many clinically unrecognized diagnoses that affect change in treatment.

METHOD: Patients ≥ 40 years, triaged as high-risk or moderate-to-high risk according to vital signs, were eligible for inclusion. Patients were scanned with a combined ECG-gated and dual energy CT scan of cerebrum, thorax, and abdomen. The impact of the CT scan on patient diagnosis and treatment was examined prospectively by an expert panel.

RESULTS: A total of 100 patients were included in the study, (53% female, mean age 73 years [age range, 43-93]). The scan lead to change in treatment or additional examinations in 37 (37%) patients, of which 24 (24%) were diagnostically significant, change in acute treatment in 11 (11%) cases and previously unrecognized malignant tumors in 10 (10%) cases. The mean size specific radiation dose was 15.9 mSv (± 3.1 mSv).

CONCLUSION: Screening with a multi-rule out CT scan of high-risk patients in an ED is feasible and result in discovery of clinically unrecognized diagnoses and malignant tumors, but at the cost of radiation exposure and downstream examinations. The clinical impact of these findings should be evaluated in a larger randomized cohort.

Original languageEnglish
JournalEmergency Radiology
Issue number4
Pages (from-to)357-365
Publication statusPublished - Aug 2018

    Research areas

  • Journal Article

ID: 53366319