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CDC: MRI and CT scan use skyrockets in the ER

by Brendon Nafziger, DOTmed News Associate Editor | September 10, 2010
Over the last decade, the use of medical imaging in the emergency room has skyrocketed, with MRI and CT scans for chest pain nearly tripling and for abdominal pain nearly doubling, according to a Centers for Disease Control and Prevention report released Friday.

"Chest and abdominal pain are the most common reasons that persons aged 15 years and over visit the emergency department," write the report authors, led by Farida A. Bhuiya. "Because EDs provide both emergency and nonemergency care, visits for these symptoms may vary in their acuity. Advanced medical imaging is often ordered to assist in both diagnosing and ruling out serious illness associated with these symptoms."

According to the CDC, between 1999 and 2008, the use of CT and MRI scans for patients coming to the ER complaining of chest pain rose almost 368 percent, jumping from use in about 3 percent of all visits to nearly 16 percent. Scans used in visits for abdominal pain also doubled, rising from about 20 percent of visits to 44 percent. For all other noninjury ED conditions, high-tech imaging scans were used in about one out of five visits, up from fewer than one in 10 nearly a decade ago.
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Still, the report notes that the growth of advanced imaging might not be an unalloyed good. Using advanced imaging could increase the amount of time patients spend in the emergency department, "thereby slowing throughput and contributing to ED crowding and its adverse consequences," the report said. But since MRI and CT scans can help physicians rule out more benign conditions and therefore avoid additional risky diagnostic or therapeutic procedures, it could also be leading to "more effective and efficient therapy."

"Targeted research is needed to clarify the extent to which medical imaging for ED visits for chest or abdominal pain is improving the diagnosis and treatment of serious conditions," the report concluded.

The Sept. 10 report, a National Center for Health Statistics Data Brief, draws on findings from the National Hospital Ambulatory Medical Care Survey from 1999-2008.