Predictors of Urgent Findings on Abdominopelvic CT in Patients with Crohn's Disease Presenting to the Emergency Department

Title
Predictors of Urgent Findings on Abdominopelvic CT in Patients with Crohn's Disease Presenting to the Emergency Department
Authors
은창수
Keywords
Crohn's disease; Computed tomography; Emergency department; Urgent finding
Issue Date
2015-04
Publisher
SPRINGER
Citation
DIGESTIVE DISEASES AND SCIENCES, v. 60, NO 4, Page. 929-935
Abstract
Background Patients with Crohn's disease (CD) are frequently exposed to diagnostic radiation, mainly as a result of abdominopelvic computed tomography (APCT) examinations. However, there are limited data on the impact of APCT on clinical management in this population. Aim To investigate clinical predictors of urgent findings on APCT in patients with CD who presented to the emergency department (ED). Methods A retrospective study was performed among patients with CD presenting to 11 EDs with a gastrointestinal complaint. The primary outcome, OPAN (obstruction, perforation, abscess, or non-CD-related urgent findings), included new or worsening CD-related urgent findings or non-CD-related urgent findings that required urgent or emergency treatment. Variables with P < 0.1 in univariate analyses were included in a multivariable logistic regression model. Results Of the 266 APCTs performed, 103 (38.7 %) had OPAN and 113 (42.5 %) required changes in treatment plan. Stricturing or penetrating disease (odds ratio [OR] 2.72, 95 % confidence interval [CI] 1.21-6.13), heart rate [100 beats/min (OR 2.33, 95 % CI 1.10-4.93), leukocyte count [10,000/mm(3) (OR 4.38, 95 % CI 2.10-9.13), and CRP [2.5 mg/dL (OR 3.11, 95 % CI 1.23-7.86) were identified as the independent predictors of OPAN, whereas biologic agent use (OR 0.37; 95 % CI 0.15-0.90) was identified as the negative predictor in patients with CD. Conclusions Only 39 % of the APCTs performed in the ED among patients with CD showed urgent findings. Stricturing or penetrating disease, tachycardia, leukocytosis, and high CRP level were predictors of urgent CT findings, while biologic agent use was a negative predictor. To reduce unnecessary radiation exposure, the selection process for CD patients referred for APCT must be improved.
URI
http://search.proquest.com/docview/1675114503?accountid=11283http://hdl.handle.net/20.500.11754/23664
ISSN
0163-2116; 1573-2568
DOI
http://dx.doi.org/10.1007/s10620-014-3298-9
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE