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Less Readmissions for Patients that Underwent CT for Atraumatic Headaches in ER Visits

By Andrew Deutsch
Posted on 14 Dec 2016
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Image: A young woman about to undergo a CT scan (Photo courtesy of Harvard Health Publications - Harvard University).
Image: A young woman about to undergo a CT scan (Photo courtesy of Harvard Health Publications - Harvard University).
A new study in the US has shown that patients admitted to an Emergency Room (ER) for atraumatic headaches who also underwent a Computed Tomography (CT) scan were less likely to return within 30 days.

The retrospective observational study, performed at Northwestern Memorial Hospital (Chicago, IL, USA), was published in the December 2016 issue of the American Journal of Roentgenology (AJR).

The researchers studied 80,619 patient visits to the ED in the study period, including 922 ED patients complaining mainly of headaches. A total of 15.1% (139 patients) returned to the ED within 30 days. Nearly twice as many (21.1%) of patients who did not undergo CT during their initial visit, returned to the ED within 30 days, compared to 11.2% for patients who underwent a CT scan.

Possible explanations for the results put forward by the researchers included that a CT scan reassured the patients of their health, or that primary care clinicians, could rule out emergent pathologies, and manage the symptoms of acute headaches better with the help of the CT scan results.

Coauthor of the study, assistant professor Brian W. Patterson, University of Wisconsin School of Medicine and Public Health (UWHealth; Madison, WI, USA), said, "I think it would be easy to misinterpret this study as a call for increasing the practice of ordering CT scans for atraumatic headache. Our findings do not support such a recommendation. Rather, we are calling attention to the downstream effects of these scans, and suggesting that future attempts to define appropriateness of imaging within the ED will need to account for their potential to lessen future care utilization. This conflict creates a need to evaluate the value added by advanced imaging performed during ED visits, and to better understand how imaging use at an initial ED visit influences subsequent resource utilization and outcomes."

Related Links:
Northwestern Memorial Hospital
University of Wisconsin School of Medicine and Public Health

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