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Войти в исследования Ultra-low-dose CT versus chest X-ray for patients suspected of pulmonary disease at the emergency department: a multicentre randomised clinical trial.
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van den Berk Inge A H, Kanglie Maadrika M N P, van Engelen Tjitske S R, Altenburg Josje, Annema Jouke T, Beenen Ludo F M, Boerrigter Bart, Bomers Marije K, Bresser Paul, Eryigit Elvin, Groenink Maarten, Hochheimer Suzanne M R, Holleman Frits, Kooter Jos A J, van Loon Ramon B, Keijzers Mitran, van der Lee Ivo, Luijendijk Paul, Meijboom Lilian J, Middeldorp Saskia, Schijf Laura J, Soetekouw Robin, Sprengers Ralf W, Montauban van Swijndregt Alexander D, de Monyé Wouter, Ridderikhof Milan L, Winter Michiel M, Bipat Shandra, Dijkgraaf Marcel G W, Bossuyt Patrick M M, Prins Jan M, Stoker Jaap, OPTIMACT study group
Аннотация
METHODS: Pragmatic, multicentre, non-inferiority randomised clinical trial in patients suspected of non-traumatic pulmonary disease at the emergency department. Between 31 January 2017 and 31 May 2018, every month, participating centres were randomly allocated to using ULDCT or CXR. Primary outcome was functional health at 28 days, measured by the Short Form (SF)-12 physical component summary scale score (PCS score), non-inferiority margin was set at 1 point. Secondary outcomes included hospital admission, hospital length of stay (LOS) and patients in follow-up because of incidental findings.
RESULTS: 2418 consecutive patients (ULDCT: 1208 and CXR: 1210) were included. Mean SF-12 PCS score at 28 days was 37.0 for ULDCT and 35.9 for CXR (difference 1.1; 95% lower CI: 0.003). After ULDCT, 638/1208 (52.7%) patients were admitted (median LOS of 4.8 days; IQR 2.1-8.8) compared with 659/1210 (54.5%) patients after CXR (median LOS 4.6 days; IQR 2.1-8.8). More ULDCT patients were in follow-up because of incidental findings: 26 (2.2%) versus 4 (0.3%).
CONCLUSIONS: Short-term functional health was comparable between ULDCT and CXR, as were hospital admissions and LOS, but more incidental findings were found in the ULDCT group. Our trial does not support routine use of ULDCT in the work-up of patients suspected of non-traumatic pulmonary disease at the emergency department.
TRIAL REGISTRATION NUMBER: NTR6163.