Incidental Findings on CT Scans in the Emergency Department

Ryan J Thompson,Paul Y Ko,William D Grant,Susan M Wojcik

doi:10.1155/2011/624847

Ryan J Thompson, Paul Y Ko + Show 2 more

Open Access

https://doi.org/10.1155/2011/624847

Copy DOI

Abstract

Objectives. Incidental findings on computed tomography (CT) scans are common. We sought to examine rates of findings and disclosure among discharged patients who received a CT scan in the ED. Methods. Retrospective chart review (Aug-Oct 2009) of 600 patients age 18 and older discharged home from an urban Level 1 trauma center. CT reports were used to identify incidental findings and discharge paperwork was used to determine whether the patient was informed of these findings. Results. There were 682 CT scans among 600 patients: 199 Abdomen & Pelvis, 405 Head, and 78 Thorax. A total of 348 incidental findings were documented in 228/682 (33.4%) of the scans, of which 34 (9.8%) were reported to patients in discharge paperwork. Patients with 1 incidental finding were less likely to receive disclosure than patients with 2 or more (P = .010). Patients age <60 were less likely to have incidental findings (P < .001). There was no significant disclosure or incidental finding difference by gender. Conclusions. While previous research suggests that CT incidental findings are often benign, reporting to patients is recommended but this is rarely happening.

Highlights

Computed tomography (CT) scans are commonly used diagnostic tools in the emergency department (ED)
At least one incidental finding was identified in 228 scans (33.4%)
Abdomen Thorax Head observed in abdominal CT scans (56.3%) was higher even than the highest rate previously reported (45%) [8]

Summary

Introduction

Included in radiology specialist’s interpretation of these scans are findings unrelated to the chief complaint and not pertinent to the immediate patient care in the emergency department. The advances in technology of the CT scanners available in most institutions have increased the resolutions and abilities of radiologists in picking up many more subtle findings While some of these incidental findings are benign and require no followup, others require serial imaging and close supervision of the patient by their primary care physician [3]. Rates of proper documentation and referral for followup of incidental findings in these groups has varied from 21% to 27% [7, 8]

Objectives

Methods

Results

Conclusion