Impact of the COVID-19 pandemic on emergency CT head utilization in Ontario-an observational study of tertiary academic hospitals.

Abstract

PurposeTo determine the impact of the Coronavirus disease-2019 (COVID-19) pandemic on the volume, indications, and results of CT heads performed in the emergency department (ED) at Canadian tertiary academic centers in Ontario.MethodsA retrospective review of consecutive CT head examinations ordered through the ED during the early stages of the COVID-19 pandemic in Canada (March 12–April 8, 2020) was performed and compared with that during the pre-COVID-19 period (February 12–March 10, 2020). CT reports were reviewed for the exam indication and the presence of predefined acute findings. A two-sample t test was utilized to compare the cohorts. Daily averages were calculated for all measures to control for the sample size difference between each period. A p value < 0.05 was considered significant.ResultsOf the total 751 CT head reports, 290 (38.6%) were ordered during the pandemic and 461 (61.4%) were ordered pre-pandemic. The average daily volume of CT head orders decreased significantly during COVID-19 compared with that during pre-COVID-19 (10.4 scans/day vs 16.5 scans/day; p = 0.001). In terms of indications, the frequency of “non-traumatic ICH” was significantly lower during COVID-19 compared with that during pre-COVID-19 (p = 0.01). Also, there was a significant increase in acute findings on CT during COVID-19 compared with that during pre-COVID-19 (p = 0.001).ConclusionThe decreased volume of emergency CT heads performed during the COVID-19 pandemic was associated with a significant increase in the proportion of cases with acute findings. This could be a result of the pandemic’s influence on the health-seeking behavior of patients as well as the decision-making process of ordering clinicians.