The American journal of emergency medicine · 2025
Impact of CT turnaround time on diagnostic and clinical outcomes in acute abdominal pain: A retrospective cohort study.
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Guo Hui, Jia Yang-Juan, Li Hong-Ling, Zhao Xin-Hua, Li Yan-Peng, Ma Zhi-Chao, Lv Ru-Yuan, Li Jian-Guo
Аннотация
OBJECTIVE: This study aimed to evaluate the effect of computed tomography (CT) turnaround time (the interval between a patient's initial visit and the availability of the CT results) on diagnostic accuracy, clinical management, and healthcare costs in patients presenting with acute abdominal pain.
METHODS: A retrospective cohort analysis was conducted involving adult patients who presented for the first time with acute abdominal pain between January 1 and June 30, 2022. Patients were stratified into two groups based on CT turnaround time, defined as the interval from clinical reception by a physician to the availability of the CT report. The early imaging group (referred to as the "priority examination group") included individuals with a CT turnaround time of less than 30 min, while the delayed/no imaging group comprised those with a turnaround time of 30 min or more, or who did not undergo CT. Outcomes were compared across emergency disease triage levels, focusing on emergency department (ED) length of stay, inpatient length of stay, hospitalization costs, diagnostic accuracy, and clinical outcomes to assess the impact of expedited imaging.
RESULTS: Of the 2450 patients identified in the electronic medical record system, 1505 met the inclusion criteria, with 839 assigned to the delayed/no imaging group and 666 to the early imaging group. Following propensity score matching, each group comprised 666 patients. No significant differences were observed between the groups regarding age or symptom onset time (p = 0.283 and 0.753, respectively). Among patients triaged as grade 2 or higher, those in the early imaging group experienced significantly shorter ED stays compared to the delayed/no imaging group (p = 0.004). However, no significant difference in ED stay was observed among grade 3 patients (p = 0.630). In patients classified as grade 2 or higher, the early imaging group exhibited a reduced inpatient length of stay and lower hospitalization costs (p = 0.001, and 0.002, respectively). Among grade 3 patients, the early imaging group incurred significantly lower emergency care costs (p < 0.001).
CONCLUSION: Shorter CT turnaround time was associated with improved diagnostic and clinical outcomes among individuals with acute abdominal pain, particularly those with higher triage severity. Early availability of CT reports correlated with reductions in ED and inpatient length of stay and overall hospitalization costs, emphasizing the clinical importance of minimizing diagnostic delays in this population.
METHODS: A retrospective cohort analysis was conducted involving adult patients who presented for the first time with acute abdominal pain between January 1 and June 30, 2022. Patients were stratified into two groups based on CT turnaround time, defined as the interval from clinical reception by a physician to the availability of the CT report. The early imaging group (referred to as the "priority examination group") included individuals with a CT turnaround time of less than 30 min, while the delayed/no imaging group comprised those with a turnaround time of 30 min or more, or who did not undergo CT. Outcomes were compared across emergency disease triage levels, focusing on emergency department (ED) length of stay, inpatient length of stay, hospitalization costs, diagnostic accuracy, and clinical outcomes to assess the impact of expedited imaging.
RESULTS: Of the 2450 patients identified in the electronic medical record system, 1505 met the inclusion criteria, with 839 assigned to the delayed/no imaging group and 666 to the early imaging group. Following propensity score matching, each group comprised 666 patients. No significant differences were observed between the groups regarding age or symptom onset time (p = 0.283 and 0.753, respectively). Among patients triaged as grade 2 or higher, those in the early imaging group experienced significantly shorter ED stays compared to the delayed/no imaging group (p = 0.004). However, no significant difference in ED stay was observed among grade 3 patients (p = 0.630). In patients classified as grade 2 or higher, the early imaging group exhibited a reduced inpatient length of stay and lower hospitalization costs (p = 0.001, and 0.002, respectively). Among grade 3 patients, the early imaging group incurred significantly lower emergency care costs (p < 0.001).
CONCLUSION: Shorter CT turnaround time was associated with improved diagnostic and clinical outcomes among individuals with acute abdominal pain, particularly those with higher triage severity. Early availability of CT reports correlated with reductions in ED and inpatient length of stay and overall hospitalization costs, emphasizing the clinical importance of minimizing diagnostic delays in this population.