Öz
Giriş: Tıbbi görüntüleme yöntemlerinin acil servislerde bulunması veya yakın olması nedeniyle çocuk ve erişkin acil servislerinde kullanımı giderek yaygınlaşmaktadır. Özellikle COVID-19 pandemisi ile birlikte bilgisayarlı tomografinin pnömoni tanısında hızlı ve duyarlı bir yöntem olarak kullanımı da artmıştır. Bu çalışma, ülkemizde son 6 yılda acil servislerde görüntüleme modalitelerindeki eğilimlerin değişimini incelemeyi amaçlamıştır.
Gereç ve Yöntemler: 1 Ocak 2016- 31 Aralık 2021 tarihleri arasında Türkiye'deki kamu ve üniversite hastanelerinin acil servislerinde retrospektif tanımlayıcı bir çalışma yapılmıştır. Görüntüleme isteklerinin (CT,MR,radyografi,USG) sayıları ve yüzdeleri analiz edildi.
Bulgular: Başvuru başına yapılan görüntülemeler değerlendirildiğinde, tüm başvurulara göre (%31-%36) en çok istenen tetkikleri düz grafiler oluşturdu. Ardından oranları CT (%10,84-%23,40) takip etti ve en yüksek CT talepleri 2020'de (n=17,192,695) bulundu. Genel olarak, görüntüleme türleri açısından yıllar arasında istatistiksel olarak anlamlı bir fark vardı (X2 65.05, p<0.001, Friedman). 2016-2017 yılları arasında tüm görüntüleme yöntemleri istatistiksel olarak değişti(p<0.001); 2017-2018(p<0,001); 2018-2019(p=0,02); 2019-2020(p<0.001). 2020 ile 2021 (p=0,614) ve 2016 ile 2021 (p=0,337) arasında istatistiksel olarak fark yokken, 2016 ile 2020 arasında istatistiksel olarak anlamlı bir fark bulundu (p=0,046).
Sonuç: Çalışmamızda acil servislerde son 6 yılda görüntüleme yöntemlerinin kullanımı incelenmiş, pandemi öncesi süreçte toplam çekim sürekli artış göstermiştir. Pandemiyle birlikte çekim modalitelerinde belirgin değişikler saptanmıştır.
Anahtar Kelimeler
Destekleyen Kurum
Yok
Kaynakça
- 1. Beştemir A, Aydın H, 300 million Patient Examinations per year; Evaluation of Emergency and Polyclinic Services of 2nd and 3rd Stage Public Health Facilities in Türkiye, 2022, Sakarya Tıp Dergisi / Sakarya Med J 2022, 12(3):496-502, DOI: 10.31832/smj.1128439
- 2. Mills AM, Raja AS, Marin JR. Optimizing diagnostic imaging in the emergency department. Acad Emerg Med. 2015 May;22(5):625–31.
- 3. Chokshi FH, Hughes DR, Wang JM, Mullins ME, Hawkins CM, Duszak R. Diagnostic Radiology Resident and Fellow Workloads: A 12-Year Longitudinal Trend Analysis Using National Medicare Aggregate Claims Data. Journal of the American College of Radiology. 2015 Jul;12(7):664–9.
- 4. Kanzaria HK, Probst MA, Ponce NA, Hsia RY. The association between advanced diagnostic imaging and ED length of stay. Am J Emerg Med. 2014 Oct;32(10):1253–8.
- 5. Sheng AY, Dalziel P, Liteplo AS, Fagenholz P, Noble VE. Focused Assessment with Sonography in Trauma and Abdominal Computed Tomography Utilization in Adult Trauma Patients: Trends over the Last Decade. Emergency Medicine International. 2013;2013:1–7.
- 6. Odle T. Emergency Computed Tomography. Radiol Technol. 2020 Jan;91(3):267CT-287CT.
- 7. Axiaq A, Almohtadi A, Massias SA, Ngemoh D, Harky A. The role of computed tomography scan in the diagnosis of COVID-19 pneumonia. Current Opinion in Pulmonary Medicine. 2021 May;27(3):163–8.
- 8. Sağlık Hizmetleri Genel Müdürlüğü. 2020. Sağlık İstatistikleri Yıllığı, 2020 [Internet]. T.C. Sağlık Bakanlığı Sağlık Bilgi Sistemleri Genel Müdürlüğü; Available from: https://sbsgm.saglik.gov.tr/Eklenti/41611/0/haber-bulteni-2020pdf.pdf
- 9. Broder J, Warshauer DM. Increasing utilization of computed tomography in the adult emergency department, 2000–2005. Emerg Radiol. 2006 Sep;13(1):25–30.
- 10. Agarwal M, Udare A, Patlas M, Ramonas M, Alaref AA, Rozenberg R, et al. Effect of COVID-19 on computed tomography usage and critical test results in the emergency department: an observational study. cmajo. 2020 Jul;8(3):E568–76.
- 11. Larson DB, Johnson LW, Schnell BM, Salisbury SR, Forman HP. National Trends in CT Use in the Emergency Department: 1995–2007. Radiology. 2011 Jan;258(1):164–73.
- 12. Kumar S, Kumar A, Goel P, Vyas S, Baitha U, Wig N. Use of ultrasonography in COVID-19: Probing for success. J Family Med Prim Care. 2020;9(8):3863.
- 13. Yadav S, Singh A, Manisha K, Khanna P. Point of Care Ultrasound in Coronavirus Disease 2019 Pandemic: One Modality Helping Multiple Specialties. J Med Ultrasound. 2021 Mar;29(1):9–14.
- 14. Reichman M, Arleo EK, Min RJ, Hentel K, Cahill M, Ruddy T, et al. Adding value in the era of COVID-19: Increasing usage of a patient-centered radiology consultation service. Clinical Imaging. 2021 Dec;80:211–4.
- 15. İlhan B, Bozdereli Berikol G, Dogan H. Impact of COVID-19 Outbreak on Emergency Visits and Emergency Consultations: A Cross-Sectional Study. Cureus [Internet]. 2021 Mar 23 [cited 2022 May 16]; Available from: https://www.cureus.com/articles/54781-impact-of-covid-19-outbreak-on-emergency-visits-and-emergency-consultations-a-cross-sectional-study
Öz
Introduction: Due to the presence or proximity of medical imaging modalities in emergency departments, their use is becoming widespread in pediatric and adult emergency departments. Especially with the COVID-19 pandemic, the use of computed tomography as a rapid and sensitive method for the diagnosis of pneumonia has also increased. This study aimed to analyse the change in the trends of imaging modalities in emergency departments over the last 6 years in our country.
Material and Methods: A retrospective descriptive study was conducted in the emergency departments of public and university hospitals in Turkey between January 1, 2016, and December 31, 2021. The numbers and percents of imaging requests (CT,MRI,radiographs,USG) were analyzed.
Results: Regarding imaging per admission were considered, Plain radiograph constituted the most requested examinations compared to all applications (31%-36%). Then, the rates were followed by CT (10.84%-23.40%), and the highest CT requests were found in 2020(n=17.192.695). Overall, there was a statistically significant difference between years in terms of imaging types (X2 65.05, p<0.001, Friedman). All imaging modalities have changed statistically between the years 2016-2017(p<0.001); 2017-2018(p<0.001); 2018-2019(p=0.02); 2019-2020(p<0.001). While there was no statistical difference between 2020 and 2021(p=0.614) also 2016 and 2021(p=0.337), a statistically significant difference was found between 2016 and 2020 (p=0.046).
Conclusion: In our study, the use of imaging methods in the emergency services in the last 6 years was examined, and the total footage showed a continuous increase in the pre-pandemic period. With the pandemic, significant changes were detected in the shooting modalities
Anahtar Kelimeler
Kaynakça
- 1. Beştemir A, Aydın H, 300 million Patient Examinations per year; Evaluation of Emergency and Polyclinic Services of 2nd and 3rd Stage Public Health Facilities in Türkiye, 2022, Sakarya Tıp Dergisi / Sakarya Med J 2022, 12(3):496-502, DOI: 10.31832/smj.1128439
- 2. Mills AM, Raja AS, Marin JR. Optimizing diagnostic imaging in the emergency department. Acad Emerg Med. 2015 May;22(5):625–31.
- 3. Chokshi FH, Hughes DR, Wang JM, Mullins ME, Hawkins CM, Duszak R. Diagnostic Radiology Resident and Fellow Workloads: A 12-Year Longitudinal Trend Analysis Using National Medicare Aggregate Claims Data. Journal of the American College of Radiology. 2015 Jul;12(7):664–9.
- 4. Kanzaria HK, Probst MA, Ponce NA, Hsia RY. The association between advanced diagnostic imaging and ED length of stay. Am J Emerg Med. 2014 Oct;32(10):1253–8.
- 5. Sheng AY, Dalziel P, Liteplo AS, Fagenholz P, Noble VE. Focused Assessment with Sonography in Trauma and Abdominal Computed Tomography Utilization in Adult Trauma Patients: Trends over the Last Decade. Emergency Medicine International. 2013;2013:1–7.
- 6. Odle T. Emergency Computed Tomography. Radiol Technol. 2020 Jan;91(3):267CT-287CT.
- 7. Axiaq A, Almohtadi A, Massias SA, Ngemoh D, Harky A. The role of computed tomography scan in the diagnosis of COVID-19 pneumonia. Current Opinion in Pulmonary Medicine. 2021 May;27(3):163–8.
- 8. Sağlık Hizmetleri Genel Müdürlüğü. 2020. Sağlık İstatistikleri Yıllığı, 2020 [Internet]. T.C. Sağlık Bakanlığı Sağlık Bilgi Sistemleri Genel Müdürlüğü; Available from: https://sbsgm.saglik.gov.tr/Eklenti/41611/0/haber-bulteni-2020pdf.pdf
- 9. Broder J, Warshauer DM. Increasing utilization of computed tomography in the adult emergency department, 2000–2005. Emerg Radiol. 2006 Sep;13(1):25–30.
- 10. Agarwal M, Udare A, Patlas M, Ramonas M, Alaref AA, Rozenberg R, et al. Effect of COVID-19 on computed tomography usage and critical test results in the emergency department: an observational study. cmajo. 2020 Jul;8(3):E568–76.
- 11. Larson DB, Johnson LW, Schnell BM, Salisbury SR, Forman HP. National Trends in CT Use in the Emergency Department: 1995–2007. Radiology. 2011 Jan;258(1):164–73.
- 12. Kumar S, Kumar A, Goel P, Vyas S, Baitha U, Wig N. Use of ultrasonography in COVID-19: Probing for success. J Family Med Prim Care. 2020;9(8):3863.
- 13. Yadav S, Singh A, Manisha K, Khanna P. Point of Care Ultrasound in Coronavirus Disease 2019 Pandemic: One Modality Helping Multiple Specialties. J Med Ultrasound. 2021 Mar;29(1):9–14.
- 14. Reichman M, Arleo EK, Min RJ, Hentel K, Cahill M, Ruddy T, et al. Adding value in the era of COVID-19: Increasing usage of a patient-centered radiology consultation service. Clinical Imaging. 2021 Dec;80:211–4.
- 15. İlhan B, Bozdereli Berikol G, Dogan H. Impact of COVID-19 Outbreak on Emergency Visits and Emergency Consultations: A Cross-Sectional Study. Cureus [Internet]. 2021 Mar 23 [cited 2022 May 16]; Available from: https://www.cureus.com/articles/54781-impact-of-covid-19-outbreak-on-emergency-visits-and-emergency-consultations-a-cross-sectional-study
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 16 Mart 2023 |
| Gönderilme Tarihi | 2 Şubat 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 13 Sayı: 1 |
Cited By
Clinical laboratory testing in the emergency department: a six-year analysis
Turkish Journal of Biochemistry
https://doi.org/10.1515/tjb-2022-0250
SMJ'de yayınlanan makaleler, Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı kapsamında lisanslanır