MRI, CT Scans for ER Patients Triple Over
TUESDAY, Oct. 5 (HealthDay News) -- The use of CT and MRI scans
for injury-related emergency room visits in the United States has
tripled since 1998, new research finds.
"There has been a dramatic increase in the likelihood of getting a CT or MRI scan during visits to emergency departments for injury-related conditions without a corresponding increase in the likelihood of diagnosing life-threatening injuries during those visits," said lead researcher Dr. Frederick Kofi Korley, an assistant professor of emergency medicine at Johns Hopkins University in Baltimore.
"Emergency departments in the United States are excellent at rapidly diagnosing and treating life-threatening illnesses, however, we need to better understand how to provide the same level of care in a cost-effective way," he added.
A CT scan can cost anywhere from $270 to $4,800, depending on
the body area scanned and hospital location, according to
comparecatscancost.com. Likewise, an MRI goes for between $400 and
$3,500, according to comparemricosts.com.
But besides raising health-care costs, scanning increases
radiation exposure and prolongs stays in the ER, according to
background information in the study, which is published in the Oct.
6 issue of the
Journal of the American Medical Association.
To assess ER use of MRIs and CTs around the country, Korley's
group used data from the National Hospital Ambulatory Medical Care
Of 324,569 emergency department visits between 1998 and 2007, 20
percent were injury-related, the researchers found.
Of 5,237 sample injury-related visits in 1998, 6 percent of the
patients received an MRI or CT. By 2007, 15 percent of 6,567
patients sampled had scans, Korley's team found. CT scans accounted
for most of the increase in imaging, they said.
Whether this growing reliance on technology improves outcomes is
In 1998, 1.7 percent of the scans revealed a life-threatening
condition, such as spine fracture in the neck, skull fracture or
bleeding of the brain, liver or spleen. In 2007, the researchers
said 2 percent of scanned patients had any of these conditions, the
Moreover, scans increased the length of time patients spent in
the emergency department by 126 minutes.
More scans did not significantly increase hospital admissions --
5.9 percent in 1998 vs. 5.5 percent in 2007. Admissions to
intensive care units also remained stable -- 0.62 percent in 1998
and 0.80 percent in 2007.
Patients 60 years or older were more likely to receive CT or MRI
scans than patients aged 18 to 45, who in turn were more likely to
get imaging than patients 18 years and younger, the researchers
One expert, Dr. Raul N. Uppot, an assistant professor at Harvard
Medical School, said the findings are flawed.
"What that the authors completely ignored, and surprisingly do not even address in their conclusion, is the impact of a negative medical imaging study," said Uppot, director of the Abdominal Imaging Fellowship Division at Massachusetts General Hospital in Boston.
Being able to tell patients that they definitively do not have
an intracranial hemorrhage, for example, is invaluable, he
"The technological ability to do this in 2010 assures the ER physician that he or she has made a correct diagnosis, reduces the wait time and uncertainty anxiety for the patient, and reduces health-care costs," Uppot said.
But, Dr. Levon Nazarian, a professor of radiology and vice
chairman for education at Thomas Jefferson University Hospital in
Philadelphia, suspects other motives lie behind the growing use of
For one thing, ER doctors are under pressure to get patients
discharged as quickly as possible, he said. By ordering an imaging
test, doctors think they can get a quicker diagnosis and move the
patient out of the emergency department faster, he said.
Another factor, one which he said is key, is increased fear of
lawsuits. "Doctors will say, 'I need this test for my own peace of
mind. If I don't do this test I may get sued,'" he added.
For more information on scans, visit the
U.S. National Library of Medicine.
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