Utility of CT oral contrast administration in the emergency department of a quaternary oncology hospital: diagnostic implications, turnaround times, and assessment of ED physician ordering
Purpose To compare studies with and without oral contrast on performance of multidetector computed tomography (CT) and the order to CT examination turnaround time in cancer patients presenting to the emergency department (ED). To the best of our knowledge, oral contrast utility has not previously be...
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| Veröffentlicht in: | Abdominal imaging 2017-11, Vol.42 (11), p.2760-2768 |
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| creator | Jensen, Corey T. Blair, Katherine J. Le, Ott Sun, Jia Wei, Wei Korivi, Brinda Rao Morani, Ajaykumar C. Wagner-Bartak, Nicolaus A. |
| description | Purpose
To compare studies with and without oral contrast on performance of multidetector computed tomography (CT) and the order to CT examination turnaround time in cancer patients presenting to the emergency department (ED). To the best of our knowledge, oral contrast utility has not previously been specifically assessed in cancer patients presenting to the emergency department.
Materials & methods
Retrospective review of CT abdomen examinations performed in oncology patients presenting to the emergency department during one month. CT examinations performed with and without oral contrast were rated by two consensus readers for degree of confidence and diagnostic ability. Correlations were assessed for primary cancer type, age, sex, chief complaint/examination indication, body mass index, intravenous contrast status, repeat CT examination within 4 weeks, and disposition. Turnaround times from order to the start of the CT examination were calculated.
Results
The studied group consisted of 267 patients (127 men and 140 women) with a mean age of 56 years and a mean body mass index of 27.8 kg/m
2
. One hundred sixty CT examinations were performed without oral contrast, and 107 CT examinations were performed with oral contrast. There was no significant difference between cases with oral contrast and cases without oral contrast in the number of cases rated as “improved confidence” (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.23–1.31,
P
= 0.17), “improved diagnosis” (OR 0.58, 95% CI 0.20–1.64,
P
= 0.3), “impaired confidence” (OR 3.92, 95% CI 0.46–33.06,
P
= 0.21), or “impaired diagnosis” (OR 2.63, 95% CI 0.29–23.89,
P
= 0.39). The turnaround time in the group receiving oral contrast (mean, 141 min; standard deviation, 49.8 min) was significantly longer than that in the group not receiving oral contrast (mean, 109.2 min; standard deviation, 64.8 min) with a mean difference of 31.8 min (
P
|
| doi_str_mv | 10.1007/s00261-017-1175-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5641226</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1951217833</sourcerecordid><originalsourceid>FETCH-LOGICAL-c437t-27ef9bcc1e63b50248fb863beda75b17cb2998f34d3952917211731b955185643</originalsourceid><addsrcrecordid>eNp1Uc1u1DAYjBCIVqUPwAVZ4kqKPzuOEw5IaGkBqRKXVuJmOY6TdZXYqT9vpX03Hg6HbVflwMlje2a-nymKt0AvgFL5ESllNZQUZAkgRSlfFKeM13VJqWheHnH166Q4R7yjlEItAJh4XZywRjBeQX1a_L5NbnJpT8JANjckRD0RE3yKGhPR_ey8w3xJLnjiPElbS-xs42i92ZPeLjqm2fq0yjW53-lko9cx23kTpjDuyTbg4pKePpHe6dEHTM4QNy-TM39d8QNJu1UTdr4nyc02v-gMNaJFfDK__EqW7R6dcdrnLnsbnR_fFK8GPaE9fzzPitury5vN9_L657cfmy_Xpam4TCWTdmg7Y8DWvBOUVc3QNRnaXkvRgTQda9tm4FXPW8FakCwvlEPXCgGNqCt-Vnw--C67bra9set-JrVEN-dZVdBO_fvj3VaN4UFlMTBWZ4P3jwYx3O8sJnUX1qEnVNAKYCAbzjMLDiwTA2K0w7ECULVmrg6Zq5y5WjNXMmvePW_tqHhKOBPYgYDLujIbn5X-r-sfHX28Ow</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1951217833</pqid></control><display><type>article</type><title>Utility of CT oral contrast administration in the emergency department of a quaternary oncology hospital: diagnostic implications, turnaround times, and assessment of ED physician ordering</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Jensen, Corey T. ; Blair, Katherine J. ; Le, Ott ; Sun, Jia ; Wei, Wei ; Korivi, Brinda Rao ; Morani, Ajaykumar C. ; Wagner-Bartak, Nicolaus A.</creator><creatorcontrib>Jensen, Corey T. ; Blair, Katherine J. ; Le, Ott ; Sun, Jia ; Wei, Wei ; Korivi, Brinda Rao ; Morani, Ajaykumar C. ; Wagner-Bartak, Nicolaus A.</creatorcontrib><description>Purpose
To compare studies with and without oral contrast on performance of multidetector computed tomography (CT) and the order to CT examination turnaround time in cancer patients presenting to the emergency department (ED). To the best of our knowledge, oral contrast utility has not previously been specifically assessed in cancer patients presenting to the emergency department.
Materials & methods
Retrospective review of CT abdomen examinations performed in oncology patients presenting to the emergency department during one month. CT examinations performed with and without oral contrast were rated by two consensus readers for degree of confidence and diagnostic ability. Correlations were assessed for primary cancer type, age, sex, chief complaint/examination indication, body mass index, intravenous contrast status, repeat CT examination within 4 weeks, and disposition. Turnaround times from order to the start of the CT examination were calculated.
Results
The studied group consisted of 267 patients (127 men and 140 women) with a mean age of 56 years and a mean body mass index of 27.8 kg/m
2
. One hundred sixty CT examinations were performed without oral contrast, and 107 CT examinations were performed with oral contrast. There was no significant difference between cases with oral contrast and cases without oral contrast in the number of cases rated as “improved confidence” (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.23–1.31,
P
= 0.17), “improved diagnosis” (OR 0.58, 95% CI 0.20–1.64,
P
= 0.3), “impaired confidence” (OR 3.92, 95% CI 0.46–33.06,
P
= 0.21), or “impaired diagnosis” (OR 2.63, 95% CI 0.29–23.89,
P
= 0.39). The turnaround time in the group receiving oral contrast (mean, 141 min; standard deviation, 49.8 min) was significantly longer than that in the group not receiving oral contrast (mean, 109.2 min; standard deviation, 64.8 min) with a mean difference of 31.8 min (
P
< 0.0001).
Conclusion
On the basis of our findings and prior studies, targeted rather than default use of oral contrast shows acceptable diagnostic ability in the emergency setting for oncology patients. Benefit from oral contrast use is suggested in scenarios such as suspected fistula/bowel leak/abscess, hypoattenuating peritoneal disease, prior bowel surgery such as gastric bypass, and the absence of intravenous contrast administration. Improvement through the use of targeted oral contrast administration also supports the emergency department need for prompt diagnosis and disposition.</description><identifier>ISSN: 2366-004X</identifier><identifier>EISSN: 2366-0058</identifier><identifier>DOI: 10.1007/s00261-017-1175-7</identifier><identifier>PMID: 28523416</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abscesses ; Administration, Oral ; Adult ; Body mass ; Body mass index ; Cancer ; Computed tomography ; Confidence intervals ; Contrast Media - administration & dosage ; Diagnosis ; Diagnostic systems ; Emergency medical services ; Emergency Service, Hospital ; Female ; Fistulae ; Gastric bypass ; Gastroenterology ; Hepatology ; Humans ; Imaging ; Intestine ; Intravenous administration ; Male ; Medical diagnosis ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasms - diagnostic imaging ; Oncology ; Patients ; Peritoneum ; Radiology ; Readers ; Retrospective Studies ; Standard deviation ; Surgery ; Tomography, X-Ray Computed - methods</subject><ispartof>Abdominal imaging, 2017-11, Vol.42 (11), p.2760-2768</ispartof><rights>Springer Science+Business Media New York 2017</rights><rights>Abdominal Radiology is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437t-27ef9bcc1e63b50248fb863beda75b17cb2998f34d3952917211731b955185643</citedby><cites>FETCH-LOGICAL-c437t-27ef9bcc1e63b50248fb863beda75b17cb2998f34d3952917211731b955185643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00261-017-1175-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00261-017-1175-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28523416$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jensen, Corey T.</creatorcontrib><creatorcontrib>Blair, Katherine J.</creatorcontrib><creatorcontrib>Le, Ott</creatorcontrib><creatorcontrib>Sun, Jia</creatorcontrib><creatorcontrib>Wei, Wei</creatorcontrib><creatorcontrib>Korivi, Brinda Rao</creatorcontrib><creatorcontrib>Morani, Ajaykumar C.</creatorcontrib><creatorcontrib>Wagner-Bartak, Nicolaus A.</creatorcontrib><title>Utility of CT oral contrast administration in the emergency department of a quaternary oncology hospital: diagnostic implications, turnaround times, and assessment of ED physician ordering</title><title>Abdominal imaging</title><addtitle>Abdom Radiol</addtitle><addtitle>Abdom Radiol (NY)</addtitle><description>Purpose
To compare studies with and without oral contrast on performance of multidetector computed tomography (CT) and the order to CT examination turnaround time in cancer patients presenting to the emergency department (ED). To the best of our knowledge, oral contrast utility has not previously been specifically assessed in cancer patients presenting to the emergency department.
Materials & methods
Retrospective review of CT abdomen examinations performed in oncology patients presenting to the emergency department during one month. CT examinations performed with and without oral contrast were rated by two consensus readers for degree of confidence and diagnostic ability. Correlations were assessed for primary cancer type, age, sex, chief complaint/examination indication, body mass index, intravenous contrast status, repeat CT examination within 4 weeks, and disposition. Turnaround times from order to the start of the CT examination were calculated.
Results
The studied group consisted of 267 patients (127 men and 140 women) with a mean age of 56 years and a mean body mass index of 27.8 kg/m
2
. One hundred sixty CT examinations were performed without oral contrast, and 107 CT examinations were performed with oral contrast. There was no significant difference between cases with oral contrast and cases without oral contrast in the number of cases rated as “improved confidence” (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.23–1.31,
P
= 0.17), “improved diagnosis” (OR 0.58, 95% CI 0.20–1.64,
P
= 0.3), “impaired confidence” (OR 3.92, 95% CI 0.46–33.06,
P
= 0.21), or “impaired diagnosis” (OR 2.63, 95% CI 0.29–23.89,
P
= 0.39). The turnaround time in the group receiving oral contrast (mean, 141 min; standard deviation, 49.8 min) was significantly longer than that in the group not receiving oral contrast (mean, 109.2 min; standard deviation, 64.8 min) with a mean difference of 31.8 min (
P
< 0.0001).
Conclusion
On the basis of our findings and prior studies, targeted rather than default use of oral contrast shows acceptable diagnostic ability in the emergency setting for oncology patients. Benefit from oral contrast use is suggested in scenarios such as suspected fistula/bowel leak/abscess, hypoattenuating peritoneal disease, prior bowel surgery such as gastric bypass, and the absence of intravenous contrast administration. Improvement through the use of targeted oral contrast administration also supports the emergency department need for prompt diagnosis and disposition.</description><subject>Abscesses</subject><subject>Administration, Oral</subject><subject>Adult</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Cancer</subject><subject>Computed tomography</subject><subject>Confidence intervals</subject><subject>Contrast Media - administration & dosage</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Emergency medical services</subject><subject>Emergency Service, Hospital</subject><subject>Female</subject><subject>Fistulae</subject><subject>Gastric bypass</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Imaging</subject><subject>Intestine</subject><subject>Intravenous administration</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasms - diagnostic imaging</subject><subject>Oncology</subject><subject>Patients</subject><subject>Peritoneum</subject><subject>Radiology</subject><subject>Readers</subject><subject>Retrospective Studies</subject><subject>Standard deviation</subject><subject>Surgery</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>2366-004X</issn><issn>2366-0058</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1Uc1u1DAYjBCIVqUPwAVZ4kqKPzuOEw5IaGkBqRKXVuJmOY6TdZXYqT9vpX03Hg6HbVflwMlje2a-nymKt0AvgFL5ESllNZQUZAkgRSlfFKeM13VJqWheHnH166Q4R7yjlEItAJh4XZywRjBeQX1a_L5NbnJpT8JANjckRD0RE3yKGhPR_ey8w3xJLnjiPElbS-xs42i92ZPeLjqm2fq0yjW53-lko9cx23kTpjDuyTbg4pKePpHe6dEHTM4QNy-TM39d8QNJu1UTdr4nyc02v-gMNaJFfDK__EqW7R6dcdrnLnsbnR_fFK8GPaE9fzzPitury5vN9_L657cfmy_Xpam4TCWTdmg7Y8DWvBOUVc3QNRnaXkvRgTQda9tm4FXPW8FakCwvlEPXCgGNqCt-Vnw--C67bra9set-JrVEN-dZVdBO_fvj3VaN4UFlMTBWZ4P3jwYx3O8sJnUX1qEnVNAKYCAbzjMLDiwTA2K0w7ECULVmrg6Zq5y5WjNXMmvePW_tqHhKOBPYgYDLujIbn5X-r-sfHX28Ow</recordid><startdate>20171101</startdate><enddate>20171101</enddate><creator>Jensen, Corey T.</creator><creator>Blair, Katherine J.</creator><creator>Le, Ott</creator><creator>Sun, Jia</creator><creator>Wei, Wei</creator><creator>Korivi, Brinda Rao</creator><creator>Morani, Ajaykumar C.</creator><creator>Wagner-Bartak, Nicolaus A.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>JQ2</scope><scope>K7-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20171101</creationdate><title>Utility of CT oral contrast administration in the emergency department of a quaternary oncology hospital: diagnostic implications, turnaround times, and assessment of ED physician ordering</title><author>Jensen, Corey T. ; Blair, Katherine J. ; Le, Ott ; Sun, Jia ; Wei, Wei ; Korivi, Brinda Rao ; Morani, Ajaykumar C. ; Wagner-Bartak, Nicolaus A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c437t-27ef9bcc1e63b50248fb863beda75b17cb2998f34d3952917211731b955185643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abscesses</topic><topic>Administration, Oral</topic><topic>Adult</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Cancer</topic><topic>Computed tomography</topic><topic>Confidence intervals</topic><topic>Contrast Media - administration & dosage</topic><topic>Diagnosis</topic><topic>Diagnostic systems</topic><topic>Emergency medical services</topic><topic>Emergency Service, Hospital</topic><topic>Female</topic><topic>Fistulae</topic><topic>Gastric bypass</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Imaging</topic><topic>Intestine</topic><topic>Intravenous administration</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasms - diagnostic imaging</topic><topic>Oncology</topic><topic>Patients</topic><topic>Peritoneum</topic><topic>Radiology</topic><topic>Readers</topic><topic>Retrospective Studies</topic><topic>Standard deviation</topic><topic>Surgery</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jensen, Corey T.</creatorcontrib><creatorcontrib>Blair, Katherine J.</creatorcontrib><creatorcontrib>Le, Ott</creatorcontrib><creatorcontrib>Sun, Jia</creatorcontrib><creatorcontrib>Wei, Wei</creatorcontrib><creatorcontrib>Korivi, Brinda Rao</creatorcontrib><creatorcontrib>Morani, Ajaykumar C.</creatorcontrib><creatorcontrib>Wagner-Bartak, Nicolaus A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Computer Science Collection</collection><collection>Computer Science Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Abdominal imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jensen, Corey T.</au><au>Blair, Katherine J.</au><au>Le, Ott</au><au>Sun, Jia</au><au>Wei, Wei</au><au>Korivi, Brinda Rao</au><au>Morani, Ajaykumar C.</au><au>Wagner-Bartak, Nicolaus A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utility of CT oral contrast administration in the emergency department of a quaternary oncology hospital: diagnostic implications, turnaround times, and assessment of ED physician ordering</atitle><jtitle>Abdominal imaging</jtitle><stitle>Abdom Radiol</stitle><addtitle>Abdom Radiol (NY)</addtitle><date>2017-11-01</date><risdate>2017</risdate><volume>42</volume><issue>11</issue><spage>2760</spage><epage>2768</epage><pages>2760-2768</pages><issn>2366-004X</issn><eissn>2366-0058</eissn><abstract>Purpose
To compare studies with and without oral contrast on performance of multidetector computed tomography (CT) and the order to CT examination turnaround time in cancer patients presenting to the emergency department (ED). To the best of our knowledge, oral contrast utility has not previously been specifically assessed in cancer patients presenting to the emergency department.
Materials & methods
Retrospective review of CT abdomen examinations performed in oncology patients presenting to the emergency department during one month. CT examinations performed with and without oral contrast were rated by two consensus readers for degree of confidence and diagnostic ability. Correlations were assessed for primary cancer type, age, sex, chief complaint/examination indication, body mass index, intravenous contrast status, repeat CT examination within 4 weeks, and disposition. Turnaround times from order to the start of the CT examination were calculated.
Results
The studied group consisted of 267 patients (127 men and 140 women) with a mean age of 56 years and a mean body mass index of 27.8 kg/m
2
. One hundred sixty CT examinations were performed without oral contrast, and 107 CT examinations were performed with oral contrast. There was no significant difference between cases with oral contrast and cases without oral contrast in the number of cases rated as “improved confidence” (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.23–1.31,
P
= 0.17), “improved diagnosis” (OR 0.58, 95% CI 0.20–1.64,
P
= 0.3), “impaired confidence” (OR 3.92, 95% CI 0.46–33.06,
P
= 0.21), or “impaired diagnosis” (OR 2.63, 95% CI 0.29–23.89,
P
= 0.39). The turnaround time in the group receiving oral contrast (mean, 141 min; standard deviation, 49.8 min) was significantly longer than that in the group not receiving oral contrast (mean, 109.2 min; standard deviation, 64.8 min) with a mean difference of 31.8 min (
P
< 0.0001).
Conclusion
On the basis of our findings and prior studies, targeted rather than default use of oral contrast shows acceptable diagnostic ability in the emergency setting for oncology patients. Benefit from oral contrast use is suggested in scenarios such as suspected fistula/bowel leak/abscess, hypoattenuating peritoneal disease, prior bowel surgery such as gastric bypass, and the absence of intravenous contrast administration. Improvement through the use of targeted oral contrast administration also supports the emergency department need for prompt diagnosis and disposition.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>28523416</pmid><doi>10.1007/s00261-017-1175-7</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2366-004X |
| ispartof | Abdominal imaging, 2017-11, Vol.42 (11), p.2760-2768 |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5641226 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Abscesses Administration, Oral Adult Body mass Body mass index Cancer Computed tomography Confidence intervals Contrast Media - administration & dosage Diagnosis Diagnostic systems Emergency medical services Emergency Service, Hospital Female Fistulae Gastric bypass Gastroenterology Hepatology Humans Imaging Intestine Intravenous administration Male Medical diagnosis Medicine Medicine & Public Health Middle Aged Neoplasms - diagnostic imaging Oncology Patients Peritoneum Radiology Readers Retrospective Studies Standard deviation Surgery Tomography, X-Ray Computed - methods |
| title | Utility of CT oral contrast administration in the emergency department of a quaternary oncology hospital: diagnostic implications, turnaround times, and assessment of ED physician ordering |
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