Effect of oral contrast for abdominal computed tom

Authors: Jeremiah D Schuur Grant Chu Andrew Sucov

Publish Date: 2009/10/20

Volume: 17, Issue: 4, Pages: 267-273

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Abstract

Computed tomography of the abdomen and/or pelvis CTAP is frequently used in the emergency department ED allowing diagnosis of a variety of conditions but requiring a prolonged period of preparation To determine whether not requiring oral contrast for CTAP reduces ED length of stay LOS Retrospective cohort of adult patients visiting an academic ED over 13 weeks around a radiology protocol change Before the change many CTAPs required oral contrast thereafter oral contrast was not required LOS was compared before and after the change among all adult ED patients Among patients undergoing CTAP adjusted LOS and time to CTAP were compared using multivariate linear regression 20464 adult ED visits occurred over the study period including 1806 where a CTAP was performed Oral contrast usage decreased from 425 of CTAP to 122 difference 303 95 confidence interval 387 to 463 There was no change in LOS among all ED visits Among ED visits where a CTAP was performed median time to CTAP decreased by 27 min and median LOS decreased by 30 min Adjusted LOS decreased from 324 min 312–337 to 297 min 285–309 Not routinely requiring oral contrast for CTAP in the ED is associated with a halfhour reduction in LOS among all patients undergoing CTAPNote Dr Schuur was a chief resident at RI Hospital in the Department of Emergency Medicine when this research was initiated conception of project IRB approval data acquisition but completed this work in his current position Dr Chu was a medical student at Brown Medical School when he participated in the research and is now at UCLA

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