Bülent DAĞLAR, Önder Murat DELİALİOĞLU, Erman CEYHAN, Güzelali ÖZDEMİR, Bülent Adil TAŞBAŞ, Kenan BAYRAKCI, Uğur GÜNEL

Acil ortopedi ve travmatoloji polikliniğinde omurga ve pelvis değerlendirmesi için gereksiz bilgisayarlı tomografi kullanımı

Amaç: Bu çalışmada, acil ortopedi polikliniğinde omurga ve pelvis bölgesinin değerlendirilmesi için istenen bilgisayarlı tomografi (BT) sıklığı, BT istenme nedenleri ve çekilen BT’lerde pozitif ve negatif inceleme oranlarının belirlenmesi amaçlandı. Çalışma planı: Ortopedi acil polikliniği tarafından bir yıl içinde (Eylül 2005-2006) BT çekilmesi istenen hastaların kayıtları incelendi. Bilgisayarlı tomografi istenme nedenleri, rapor edilen bulgular, hastaların yaş ve cinsiyetleri kaydedildi. İstem ile ilişkili olmayan bulgular içeren incelemeler negatif, istem ile uyumlu bulgular saptananlar pozitif BT olarak kabul edildi. Sonuçlar: Ortopedi acil polikliniğine yapılan toplam 24378 başvurunun 1295’inde (%5.3) BT incelemesi istendi. Bunların 817’si (%63.1) omurga ve pelvis incelemeleriydi. Bu incelemelerin 418’i (%51.2) negatif BT olarak değerlendirildi. Negatif BT’li hastaların yaş ortalaması, pozitif BT’li hastalara göre anlamlı derecede düşük bulundu (sırasıyla 40.7 ve 45.1 yıl, p=0.001). Tüm grup için, negatif ve pozitif BT’li hastalar arasında cinsiyet dağılımı açısından farklılık saptanmadı (p=0.670). Omurga BT incelemelerinde bulunan negatiflik oranı, pelvis için saptanan orandan göre anlamlı derecede yüksek idi (p

Anahtar Kelimeler:

Tomografi, x-ışınlı bilgisayarlı, Gereksiz işlemler, Acil tedavi, Pelvis, Geriyedönük çalışma, Tıbbi kayıtlar, Omurilik yaralanmaları, Sonuç değerlendirilmesi (Sağlık bakımı), Ortopedik işlemler

Superfluous computed tomography utilization for the evaluation of the pelvis and spinal column in an orthopedic emergency department

Objectives: This study was designed to investigate the frequency of requests for computed tomography (CT) examination of the spinal column and pelvis in our emergency orthopedic department, the reasons of requests, and the rates of positive and negative CT examinations. Methods: We retrospectively reviewed patients for whom a request for CT examination was made by the emergency orthopedic department within a year (September 2005- 2006). The reasons for CT requests, findings in CT reports, and age and sex of the patients were recorded. Findings unrelated and related to the original request denoted a negative and positive CT examination, respectively. Results: Of 24,378 admissions to our emergency orthopedic department, a CT scan was requested in 1295 patients (5.3%). In 817 patients (63.1%), CT examination involved the pelvis or the spinal column. Of these, 418 CT scans (51.2%) yielded a negative result. The mean age of the patients with a negative CT scan was significantly lower than those having a positive CT scan (40.7 vs 45.1 years; p=0.001). There was no significant difference with respect to sex between patients having negative and positive CT findings (p=0.670). Compared to pelvis CT scans, the frequency of negative CTs was significantly higher for spinal column examinations (p<0.001). The incidence of negative CT scans for upper thoracic and cervical vertebrae was significantly higher than that found for lower thoracic and lumbar regions (p<0.001). Conclusion: The high incidence of negative CT scans documented for SARI NOKRA Hastalığu pelvic and spinal column examinations underlines the need for measures to avoid superfluous CT requests in emergency departments.

Keywords:

Tomography, X-Ray Computed, Unnecessary Procedures, Emergency Treatment, Pelvis, Retrospective Studies, Medical Records, Spinal Injuries, Outcome Assessment (Health Care), Orthopedic Procedures,

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