2012年2月6日星期一

CT scans not cost-effective on dizzy ER patients


    Patients admitted to the emergency room with dizziness often get a CT scan to rule out stroke. But an abstract of a study presented last week at a Florida medical conference suggests ordering CT scans for dizzy patients might not be cost-effective.


      The study, conducted by Henry Ford Hospital researchers in Detroit, found that although nearly half of all patients complaining of dizziness and vertigo got a CT scan, fewer than 1 percent had any significant pathology that required intervention.


      During the three-year period of the study, nearly $1 million was spent on brain CTs of the patients, the researchers said. As a result, the researchers argued "stricter guidelines" for ordering CT scans in the ER for dizzy patients could generate cost savings.


      "It is our hope that our investigation into our own practices will shed light on avenues to run leaner practices within our institution as well as serve as a model for other health care systems," the authors wrote in the abstract. The authors were Drs. Syed F. Ahsan, neuro-otologist at Henry Ford, Mausumi N. Syamal and Kathleen Yaremchuk.


      The study, which ran from January 2008 to January 2011 at a Detroit city ER, involved 1,681 patients, 810 of whom received brain or head CTs, of which only 0.74 percent were clinically significant. Older and poorer patients were more likely to get scanned, according to the authors' analysis.


      The study, which has not appeared yet in a peer-reviewed journal, was presented Jan. 26 at the Triological Society's Combined Sections Meeting in Miami Beach.

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