Objective Urinary tract infection (UTI) is a significant issue in young febrile patients due to potential long-term complications. Early detection of UTI is crucial in pediatric emergency departments (PEDs). We developed a tool to predict UTIs in children.
Methods Clinical data of patients <24 months of age with a fever and UTI or viral infection were extracted from the fever registry collected in two PEDs. Stepwise multivariate logistic regression was performed to establish predictors of identified eligible clinical variables for the derivation of the prediction model.
Results A total of 1,351 patients were included in the analysis, 643 patients from A hospital (derivation set) and 708 patients from B hospital (validation set). In the derivation set, there were more girls and a lower incidence of a past history of UTI, older age, less fever without source, and more family members with upper respiratory symptoms in the viral infection group. The stepwise regression analysis identified sex (uncircumcised male), age (≤12 months), a past history of UTI, and family members with upper respiratory symptoms as significant variables.
Conclusion Young febrile patients in the PED were more likely to have UTIs if they were uncircumcised boys, were younger than 12 months of age, had a past history of UTIs, or did not have families with respiratory infections. This clinical prediction model may help determine whether to perform urinalysis in the PED.
Citations
Citations to this article as recorded by
Diagnosis of urinary tract infections in the pediatric population – current practices, advances and progress Maria Bitsori, Roza-Ioanna Poulaki, Emmanouil Galanakis Expert Review of Anti-infective Therapy.2026; 24(1): 139. CrossRef
Pediatric malaria in a non-endemic European setting: clinical patterns, laboratory markers, and the ambiguous role of immunity Roberta Caiazzo, Benedetta Panero, Marta Carello, Crescenzo Coppola, Raffaella Di Tonno, Anna Hermine Markowich, Marta Stracuzzi, Maria Sole Valentino, Silvia Grosso, Anna Gigantiello, Vania Giacomet Infection.2026;[Epub] CrossRef
Role of the National Early Warning score and Modified Early Warning score for predicting mortality in geriatric patients with non-traumatic coma Dong Ki Kim, Dong Hun Lee, Byung Kook Lee Heliyon.2024; 10(6): e28338. CrossRef
Objective The use of computed tomography (CT) in pediatric patients has decreased since the association between radiation and cancer risk has been reported. However, in adolescent patients being treated as adult patients, there has been a high incidence of CT use in emergency departments (EDs). Thus, this study aimed to evaluate the CT use in adolescent patients with complaints of headache or abdominal pain in the general and pediatric EDs of the same hospital.
Methods A retrospective chart review of patients aged 15 to 18 years, who presented with headache or abdominal pain at the general and pediatric EDs of Seoul National University Hospital from January 2010 to December 2014, was conducted.
Results A total of 407 adolescent patients with complaints of headache and 980 with abdominal pain were included in this study. The adolescent patients in the general ED were more likely to undergo CT scans than those in the pediatric ED, with both patients having headache (42.4% vs. 20.5%, respectively, P<0.001) and abdominal pain (29.0% vs. 18.4%, respectively, P<0.001). There was no statistical difference in the rates of positive CT findings between the general and pediatric EDs. The frequency of visits to the general ED was associated with high rates of CT use in adolescent patients with complaints of headache (odds ratio, 3.95; 95% confidence interval, 2.01 to 7.77) and those with abdominal pain (odds ratio, 1.76; 95% confidence interval, 1.18 to 2.64).
Conclusion The ED setting influences the use of CT on adolescent patients, and a child-friendly environment could reduce the radiation risks.
Citations
Citations to this article as recorded by
Diagnostic value of CT scans in pediatric patients with acute non-traumatic altered mental status: a systematic review and meta-analysis Mohammed Alsabri, Mohammed Ayyad, Mayar M. Aziz, Mohamed Sayed Zaazouee, Alaa Ahmed Elshanbary, Muhammad Ashir Shafique, Lamar Sarieddine, Ibrahim Qattea, Muhammad Waseem, Luis L. Gamboa European Journal of Pediatrics.2025;[Epub] CrossRef
Lesson from a Single Pediatric Emergency Department: Potentially Applicable Radiation-Minimizing Practices for Non-Traumatic Abdominal Pain in Adolescents Min Kyo Chun, Reenar Yoo, Soo-young Lim, Dahyun Kim, Jeeho Han, Seung Jun Choi, Jeong-Yong Lee, Jong Seung Lee, Jun Sung Park Children.2025; 12(10): 1306. CrossRef
Diagnostic performance of artificial intelligence for pediatric pulmonary nodule detection on chest computed tomography: comparison of simulated lower radiation doses Rida Salman, HaiThuy N. Nguyen, Andrew C. Sher, Kristina Hallam, Victor J. Seghers, Marla B. K. Sammer European Journal of Pediatrics.2023; 182(11): 5159. CrossRef
The Value of Cranial CT Imaging in Patients With Headache at the Emergency Department Cynthia M. C. Lemmens, M. Christien van der Linden, Korné Jellema Frontiers in Neurology.2021;[Epub] CrossRef
The use of a pediatric appendicitis pathway in a large integrated health system reduced computed tomography imaging in the ED Emine Tunc, Erika Fraundorf, Sarah Worley, Michael Aquino, David Magnuson, Brooke S. Lampl, Stephanie Jennings, Baruch S. Fertel The American Journal of Emergency Medicine.2021; 50: 211. CrossRef
Diaphragmatic rupture with inferior phrenic artery bleeding caused by cardiopulmonary resuscitation Umberto G. Rossi, Anna Maria Ierardi, Maurizio Cariati Clinical and Experimental Emergency Medicine.2020; 7(3): 238. CrossRef
Objective The aim of this study was to investigate the effectiveness of a quality improvement activity for pain management in patients with extremity injury in the emergency department (ED).
Methods This was a retrospective interventional study. The patient group consisted of those at least 19 years of age who visited the ED and were diagnosed with International Classification of Diseases codes S40–S99 (extremity injuries). The quality improvement activity consisted of three measures: a survey regarding activities, education, and the triage nurse’s pain assessment, including change of pain documentation on electronic medical records. The intervention was conducted from January to April in 2014 and outcome was compared between May and August in 2013 and 2014. The primary outcome was the rate of analgesic prescription, and the secondary outcome was the time to analgesic prescription.
Results A total of 1,739 patients were included, and 20.3% of 867 patients in the pre-intervention period, and 28.8% of 872 patients in the post-intervention period received analgesics (P< 0.001). The prescription rate of analgesics for moderate-to-severe injuries was 36.4% in 2013 and 44.5% in 2014 (P=0.026). The time to analgesics prescription was 116.6 minutes (standard deviation 225.6) in 2013 and 64 minutes (standard deviation 75.5) in 2014 for all extremity injuries. The pain scoring increased from 1.4% to 51.6%.
Conclusion ED-based quality improvement activities including education and change of pain score documentation can improve the rate of analgesic prescription and time to prescription for patients with extremity injury in the ED.
Citations
Citations to this article as recorded by
Time from pain assessment to opioid treatment in the Danish emergency departments—A multicenter cohort study Katrine H. Gull, Marianne Lisby, Sara V. Leth, Stine F. Galili Acta Anaesthesiologica Scandinavica.2025;[Epub] CrossRef
Improving door-to-analgesia timing in musculoskeletal injuries in an academic emergency department in India: a quality improvement project Anuusha Sadasivam S, Aswin Kumaran, S Manu Ayyan, S N Sindujaa BMJ Open Quality.2024; 13(2): e002815. CrossRef
Assessment of the implementation of a nurse-initiated pain management protocol in the emergency department Marcia Boessio dos Santos, Cristiana Maria Toscano, Ruth Ester Assayag Batista, Elena Bohomol Revista Brasileira de Enfermagem.2021;[Epub] CrossRef
The investigation of open hand injury patients presenting to emergency department İsa Gökhan YALÇIN, Cihan BEDEL, Önder TOMRUK, Nesrin Gökben BECEREN, Hamit Hakan ARMAĞAN Journal of Health Sciences and Medicine.2018; 1(4): 75. CrossRef
Objective Many studies have proposed reducing unnecessary use of computed tomography (CT), and ongoing studies in pediatric populations are aiming to decrease radiation dosages whenever possible. We aimed to evaluate the long-term changes in the utilization patterns of CT and ultrasound (US) in pediatric emergency departments (PEDs).
Methods This retrospective study reviewed the electronic medical data of patients who underwent CT and/or US in the PED of a tertiary referral hospital from 2000 to 2014. We compared the changes in utilization patterns of brain and abdominal CT scans in pediatric patients and analyzed changes in abdominal US utilization in the PED.
Results During the study period, 196,371 patients visited the PED. A total of 12,996 brain and abdominal CT scans and 12,424 abdominal US were performed in the PED. Comparison of CT use in pediatric patients before and after 2007 showed statistically decreasing trends after 2007, expressed as the coefficient values of the differences in groups. The numbers of brain and abdominal CT scans showed a significant decreasing trend in children, except for abdominal CT in adolescents. The abdominal US/CT ratio in the PED showed a statistically significant increase (2.68; 95% confidence interval, 1.87 to 3.49) except for the adolescent group (5.82; 95% confidence interval, -2.06 to 13.69).
Conclusion Overall, CT use in pediatric patients has decreased since 2007. Pediatric US use has also shown a decreasing trend; however, the abdominal US/CT ratio in pediatric patients showed an increasing trend, except for adolescents.
Citations
Citations to this article as recorded by
Lesson from a Single Pediatric Emergency Department: Potentially Applicable Radiation-Minimizing Practices for Non-Traumatic Abdominal Pain in Adolescents Min Kyo Chun, Reenar Yoo, Soo-young Lim, Dahyun Kim, Jeeho Han, Seung Jun Choi, Jeong-Yong Lee, Jong Seung Lee, Jun Sung Park Children.2025; 12(10): 1306. CrossRef
The Pattern of CT Scan Use in the Diagnosis of Abdominal Pain in Children Presenting to the Emergency Department of a Tertiary Community Hospital Hamza H Khan, Shova Subedi, Sanjay Kumar, Hernando Lyons Cureus.2021;[Epub] CrossRef
Objective The aim of this study was to elucidate the epidemiology of pediatric patients transported by the National 119 Rescue Services in Korea.
Methods We enrolled all pediatric patients (<16 years old) who used the National 119 Rescue Services in Korea between January 2006 and December 2008, and analyzed the 119 ambulance patient care record databases.
Results The total number of the cases was 238,644 for 3 years. The median age was 6 years old and 59.0% were male, and the 2- to 5-year-old group was the largest (31.0%). The peak transport times were in the afternoon (from 12:00 p.m. to 17:59 p.m., 36.3%), on Saturday and Sunday (15.9% and 15.7%), and in summer (June to August, 27.3%). The ratio of disease versus injury as the cause of the transports was 42.3% vs. 57.7%. Among the 16 metropolitan cities and provinces, Gyeonggi (25.7%), Seoul (17.6%), and Incheon (7.0%) account for almost half of the all transported children. Regarding the annual transport rates per 100,000 children standardized by age, and gender to the Korean child population, Jeju was the largest (1,650.2) followed by Gangwon (1,201.3), and Jeonnam (1,178.1).
Conclusion This report presents comprehensive epidemiologic data of pediatric patients transported by 119 rescue services in Korea.
Citations
Citations to this article as recorded by
The prehospital paediatric emergency care burden managed by a public ambulance service in the Western Cape, South Africa Naseef Abdullah, Naqeeb Majiet, Simpiwe Sobuwa BMC Emergency Medicine.2024;[Epub] CrossRef
Paediatric frequent use of emergency medical services: a systematic review Jason Scott, Ashrafunessa Khanom, Joanne Straw, Annette Strickland, Alison Porter, Helen Snooks Emergency Medicine Journal.2023; 40(1): 20. CrossRef
The influence of age on transfer of pediatric trauma patients after initial transport to hospitals with a higher capacity for general emergency care Seungmin Jeong, Ki Ok Ahn, Jungeun Kim, Sang Do Shin, Young Sun Ro Journal of EMS Medicine.2022; 1(1): 6. CrossRef
Effect of the COVID-19 outbreak on emergency transport of children by an emergency medical service system: a population-based, ORION registry study Koshi Ota, Daisuke Nishioka, Yusuke Katayama, Tetsuhisa Kitamura, Jun Masui, Kanna Ota, Masahiko Nitta, Tetsuya Matsuoka, Akira Takasu BMC Emergency Medicine.2022;[Epub] CrossRef
Why do infants need out-of-hospital emergency medical services? A retrospective, population-based study Jelena Oulasvirta, Heini Harve-Rytsälä, Mitja Lääperi, Markku Kuisma, Heli Salmi Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2021;[Epub] CrossRef
Epidemiologic Characteristics of Injured School-age Patients Transported via Emergency Medical Services in Korea Hang A Park, Ki Ok Ahn, Ju Ok Park, Jungeun Kim, Seungmin Jeong, Meesook Kim Journal of Korean Medical Science.2018;[Epub] CrossRef
Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department Sang Bum Lee, Jae Hun Oh, Jeong Ho Park, Seung Pill Choi, Jung Hee Wee Clinical and Experimental Emergency Medicine.2018; 5(4): 249. CrossRef
Strengthening the role of pediatric emergency centers in Korea Jin Hee Jung, Young Ho Kwak, Hyun Noh Pediatric Emergency Medicine Journal.2017; 4(2): 29. CrossRef
Prehospital transport of critically ill children via 119 emergency medical service providers: problems and improvement plan Hyun Noh Pediatric Emergency Medicine Journal.2017; 4(2): 34. CrossRef
Jin Hee Jeong, Jin Hee Lee, Kyuseok Kim, Joong Eui Rhee, Tae Yun Kim, You Hwan Jo, Yu Jin Kim, Jae Hyuk Lee, Changwoo Kang, Soo Hoon Lee, Joonghee Kim, Chan Jong Park, Hyuksool Kwon
Clin Exp Emerg Med 2015;2(4):226-235. Published online December 28, 2015
Objective Head injury in children is a common problem presenting to emergency departments, and cranial computed tomography scanning is the diagnostic standard for these patients. Several decision rules are used to determine whether computed tomography scans should be used; however, the use of computed tomography scans is often influenced by guardians’ preference toward the scans. The objective of this study was to identify changes in guardian preference for minor head injuries after receiving an explanation based on the institutional clinical practice guideline.
Methods A survey was conducted between July 2010 and June 2012. Patients younger than 16 years with a Glasgow Coma Scale score of 15 after a head injury and their guardians were included. Pre- and post-explanation questionnaires were given to guardians to assess their preference for computed tomography scans and factors related to the degree of preference. Treating physicians explained the risks and benefits of cranial computed tomography scanning using the institutional clinical practice guideline. Guardian preference for a computed tomography scan was examined using a 100-mm visual analog scale.
Results In total, 208 patients and their guardians were included in this survey. Guardian preference for computed tomography scans was significantly reduced after explanation (46.7 vs. 17.4, P<0.01). Pre-explanation preference and the strength of the physician recommendation to get a computed tomography were the most important factors affecting pre- and post-explanation changes in preferences.
Conclusion Explanation of the risks and benefits of cranial computed tomography scans using the institutional clinical practice guideline may significantly reduce guardian preference for computed tomography scans.
Citations
Citations to this article as recorded by
Optimizing Advanced Imaging of the Pediatric Patient in the Emergency Department: Technical Report Jennifer R. Marin, Todd W. Lyons, Ilene Claudius, Mary E. Fallat, Michael Aquino, Timothy Ruttan, Reza J. Daugherty Journal of the American College of Radiology.2024; 21(7): e37. CrossRef
Optimizing Advanced Imaging of the Pediatric Patient in the Emergency Department: Technical Report Jennifer R. Marin, Todd W. Lyons, Ilene Claudius, Mary E. Fallat, Michael Aquino, Timothy Ruttan, Reza J. Daugherty, Gregory P. Conners, Sylvia Owusu-Ansah, Kerry S. Caperell, Jennifer Hoffmann, Benson Hsu, Deborah Hsu, Jennifer E. McCain, Mohsen Saidinej Pediatrics.2024;[Epub] CrossRef
Risk stratification of intermediate-risk children with minor head injury: a secondary publication translated into Korean Jung Heon Kim Pediatric Emergency Medicine Journal.2022; 9(1): 1. CrossRef
Clinical Decision Rule to Identify Orbital Wall Fracture Among Children So Hyun Paek, Jin Hee Jung, Young Ho Kwak, Do Kyun Kim, Jin Hee Lee, Jae Yun Jung, Sohee Oh Pediatric Emergency Care.2020; 36(5): e280. CrossRef
Risk Stratification of Intermediate-Risk Children With Minor Head Injury Yura Ko, Ji Sook Lee, Minjung Kathy Chae, Jung Hwan Ahn, Hyuk-Hoon Kim, Eun Jung Park, Jung Heon Kim Pediatric Emergency Care.2020; 36(11): e659. CrossRef
Is cranial computed tomography unnecessary in children with a head injury and isolated vomiting? Simon Hardman, Ola Rominiyi, David King, Edward Snelson BMJ.2019; : l1875. CrossRef
Objective The overall use of Computed Tomography (CT) continues to grow inside the hospital. Despite CT imaging is a valuable diagnostic technique, the relatively high radiation doses associated with CT compared with conventional radiography have raised health concerns such as future cancer risk. We investigated the awareness level concerning radiation dose and possible risks associated with CT scans in medical personnel (MP).
Methods and materials: This study was conducted from April to May 2012. Physicians and nurses who worked in emergency department of 17 training hospitals were enrolled in the survey. The questionnaire included the degree of CT scan or radiography affecting health using a 10 numerical rating scale, estimation of the radiation dose for the CT scan compared with one chest radiograph, and the perception of the increased lifetime cancer risk of CT scan.
Results A total of 354 MP participated in this study. They included 142 nurses, 87 interns, 86 residents, and 39 specialists. Interns were less aware of CT scan or radiography affecting health than other physicians or nurses (4.8±2.7 vs. 5.9±2.7 vs. 6.1±2.7 vs. 6.0±2.2, interns vs. residents vs. faculties vs. nurses, respectively. mean (SD). p < 0.05). There was significant difference in the knowledge about the relative radiation dose of the CT scan for one chest radiograph between doctors and nurses (48.6% vs. 28.9%, doctors vs. nurses, p < 0.05). MPs perceived increased cancer risk from radiation of CT scan.
Conclusions Medical personnels perceived the radiation risk associated with CT scan, but seems to be insufficient.
Citations
Citations to this article as recorded by
A Flowchart to Guide Emergency Physicians to Order Radiological Imaging in Pregnant Patients: Findings from an Emergency Department Questionnaire Fatih Cemal Tekin, Abdullah Enes Ataş, Fulya Köse, Demet Acar Healthcare.2025; 13(23): 3138. CrossRef
Establishment of CT diagnostic reference levels (DRLs) for a Singapore healthcare cluster L. Arlany, H.G. Toh, B. Nazir, J.J. Ng, Y.H. Tay, Y.S. Tay, C.J.X. Poon, L.N. Lee, W.K.S. Fum, E.Y.T. Lee, S.I. Mariah, M.V. Fortier, W.P. Tham, L.L. Chew, K.H.E. Chong, L.R. Chong Radiography.2023; 29(1): 184. CrossRef
Do physicians counsel patients regarding radiation risks of CT?: A survey of emergency department patients Elizabeth Sullivan, Brook Danboise, Kaitlin Hunt, Mary Hamblen, Michael Simmons, Shreya Kumar, Peter Richman The American Journal of Emergency Medicine.2023; 71: 233. CrossRef
Strategies for Dose Optimization: Views From Health Care Systems Robin R. Whitebird, Leif I. Solberg, Philip W. Chu, Rebecca Smith-Bindman Journal of the American College of Radiology.2022; 19(4): 534. CrossRef
Patients’ perception of radiation safety of radiological investigations in urology Prakrit R Kumar, Stuart Irving Journal of Clinical Urology.2021; 14(6): 475. CrossRef
Objective Pulmonary edema is frequently observed after a successful resuscitation in out-of hospital cardiac arrest (OHCA) patients. Currently, its risk factors and prognostic implications are mostly unknown.
Methods Adult OHCA patients with a presumed cardiac etiology who achieved sustained return of spontaneous circulation (ROSC) in emergency department were retrospectively analyzed. The patients were grouped according to the severity of consolidation on their initial chest X-ray (group I, no consolidation; group II, patchy consolidations; group III, consolidation involving an
entire lobe; group IV, total white-out of any lung). The primary objective was to identify the risk factors of developing severe pulmonary edema (group III or IV). The secondary objective was to evaluate the association between long-term prognosis and the severity of pulmonary edema.
Results One hundred and seven patients were included. Total duration of cardiopulmonary resuscitation (CPR) and initial pCO2 level were both independent predictors of developing severe pulmonary edema with their odds ratio (OR) being 1.02 (95% confidence interval [CI], 1.00 to 1.04; per 1 minute) and 1.04 (95% CI, 1.01 to 1.07; per 1 mmHg), respectively. The long term
prognosis was significantly poor in patients with severe pulmonary edema with a OR for good outcome (6-month cerebral performance category 1 or 2) being 0.22 (95% CI, 0.06 to 0.79) in group III and 0.16 (95% CI, 0.04 to 0.63) in group IV compared to group I.
Conclusion The duration of CPR and initial pCO2 level were both independent predictors for the development of severe pulmonary edema after resuscitation in emergency department. The severity of the pulmonary edema was significantly associated with long-term outcome.
Citations
Citations to this article as recorded by
Rediscovery of acute lung injury in cardiac arrest: Breathing fresh air into a neglected component of the post-cardiac arrest syndrome Willard W. Sharp, Lin Piao Resuscitation.2025; 207: 110495. CrossRef
Cardiac arrest related lung edema: examining the role of downtimes in transpulmonary thermodilution analysis Ingo Voigt, Marco Mighali, Heinrich Wieneke, Oliver Bruder Internal and Emergency Medicine.2024; 19(2): 501. CrossRef
Super-refractory status epilepticus, rhabdomyolysis, central hyperthermia and cardiomyopathy attributable to spinal anesthesia: a case report and review of literature N. D.B. Ehelepola, R. M.D.C. Ranathunga, A. B. Abeysundara, H. M.R.P. Jayawardana, P. S.K. Nanayakkara BMC Anesthesiology.2024;[Epub] CrossRef
Lung parenchymal and pleural findings on computed tomography after out-of-hospital cardiac arrest Maranda Newton, Jane Hall, Catherine R. Counts, Navya Gunaje, Basar Sarikaya, Vasisht Srinivasan, Kelley R.H. Branch, Nicholas J. Johnson Resuscitation.2024; 205: 110446. CrossRef
Acute kidney injury in COVID 19 – an update on pathophysiology and management modalities Manoj Khokhar, Purvi Purohit, Dipayan Roy, Sojit Tomo, Ashita Gadwal, Anupama Modi, Mithu Banerjee, Praveen Sharma Archives of Physiology and Biochemistry.2023; 129(3): 626. CrossRef
What caused this patient's cardiac arrest? Olga Lender JAAPA.2023; 36(7): 46. CrossRef
Radiographic assessment of lung edema (RALE) score is associated with clinical outcomes in patients with refractory cardiogenic shock and refractory cardiac arrest after percutaneous implantation of extracorporeal life support Ingo Voigt, Marco Mighali, Daniela Manda, Phillip Aurich, Oliver Bruder Internal and Emergency Medicine.2022; 17(5): 1463. CrossRef
H2O2-Responsive Antioxidant Nanoparticle Attenuates Whole Body Ischemia/Reperfusion-Induced Multi-Organ Damages Ruijian Li, Sang Jae Rhee, Soochan Bae, Shi Su, Chang-Sun Kang, Qingen Ke, Ye Eun Koo, Chloe Ryu, Chul Gyu Song, Dongwon Lee, Peter M. Kang Journal of Cardiovascular Pharmacology and Therapeutics.2021; 26(3): 279. CrossRef
The effect of the head-up position on cardiopulmonary resuscitation: a systematic review and meta-analysis Cheng-Chieh Huang, Kuan-Chih Chen, Zih-Yang Lin, Yu-Hsuan Chou, Wen-Liang Chen, Tsung-Han Lee, Kun-Te Lin, Pei-You Hsieh, Cheng Hsu Chen, Chu-Chung Chou, Yan-Ren Lin Critical Care.2021;[Epub] CrossRef
Radiologically and clinically diagnosed acute pulmonary oedema in critically ill patients: prevalence, patient characteristics, treatments and outcomes Khaled El-Khawas, Danielle Richmond, Lara Zwakman-Hessels, Salvatore L. Cutuli, Alessandro Belletti, Thummaporn Naorungroj, Hussam Abdelkarim, Natalie Yang, Rinaldo Bellomo Critical Care and Resuscitation.2021; 23(2): 154. CrossRef
The gradient between arterial and end-tidal carbon dioxide predicts in-hospital mortality in post-cardiac arrest patient Yong Won Kim, Sung Oh Hwang, Hee Seung Kang, Kyoung-Chul Cha The American Journal of Emergency Medicine.2019; 37(1): 1. CrossRef
Effect of mild hypothermia on lung injury after cardiac arrest in swine based on lung ultrasound Chunshuang Wu, Jiefeng Xu, Xiaohong Jin, Qijiang Chen, Zilong Li, Mao Zhang BMC Pulmonary Medicine.2019;[Epub] CrossRef
The relationship between low survival and acute increase of tumor necrosis factor α expression in the lung in a rat model of asphyxial cardiac arrest Yoonsoo Park, Hyun-Jin Tae, Jeong Hwi Cho, In-Shik Kim, Taek Geun Ohk, Chan Woo Park, Joong Bum Moon, Myoung Cheol Shin, Tae-Kyeong Lee, Jae-Chul Lee, Joon Ha Park, Ji Hyeon Ahn, Seok Hoon Kang, Moo-Ho Won, Jun Hwi Cho Anatomy & Cell Biology.2018; 51(2): 128. CrossRef
Inhibition of RHO Kinase by Fasudil Attenuates Ischemic Lung Injury After Cardiac Arrest in Rats Jian Wei, Peng Wang, Yi Li, Qingli Dou, Jiali Lin, Wuyuan Tao, Jinle Lin, Xuan Fu, Zitong Huang, Wenwu Zhang Shock.2018; 50(6): 706. CrossRef
Sodium bicarbonate administration during ongoing resuscitation is associated with increased return of spontaneous circulation Joonghee Kim, Kyuseok Kim, Jongdae Park, You Hwan Jo, Jae Hyuk Lee, Ji Eun Hwang, Chulmin Ha, Young-sang Ko, Euigi Jung The American Journal of Emergency Medicine.2016; 34(2): 225. CrossRef
ED crowding and the outcomes of out-of-hospital cardiac arrest Jiwon Kang, Joonghee Kim, You Hwan Jo, Kyuseok Kim, Jae Hyuk Lee, Taeyun Kim, Jungyoup Lee, Ji Eun Hwang, Euigi Jung The American Journal of Emergency Medicine.2015; 33(11): 1659. CrossRef
Objective Cardiac computed tomography (CCT) is useful for evaluation of acute chest pain in the emergency department (ED). Though the test needs proper interpretation by someone with expertise in cardiovascular imaging, the critical nature of the information the test provides frequently lead emergency physicians (EPs) to act on their own interpretation. We performed this study to assess how often EPs’ interpretations are in agreement with radiologists’.
Methods This study is a prospective observational study. The target population was patients assessed with CCT for acute chest pain or discomfort. EPs with at least one year CCT experience underwent a one-hour training session before study participation. The most significant lesion, if any, in each arterial segment was assessed for coronary stenosis and plaque calcification. The agreement between EPs’ and radiologists’ interpretation was assessed with Cohen’s kappa and Gwet’s AC1.
Results One hundred and three patients were enrolled and 412 segments were analyzed. Stenosis grading was identical in 363 segments (88.1%) and the interrater agreement was good (kappa=0.6439, AC1=0.8810). Similarly, the plaque calcification grading was identical in 354 segments (86.6%) and the kappa and AC1 values were 0.5660 and 0.8501, respectively. EPs classified 6 of the 17 arterial segments with significant stenosis reported by radiologists as non-significant stenosis (n=5) or clear (n=2), all of which were proved to be significant by following subsequent invasive coronary angiography.
Conclusion There was substantial discordance of CCT interpretation between EPs and radiologists. For now, EPs need more education prior to independent CCT reading.
Citations
Citations to this article as recorded by
Comparison of abdominal ct interpretation levels of emergency physicians and radiologists Kasim Turgut Adıyaman Üniversitesi Sağlık Bilimleri Dergisi.2019; 5(2): 1482. CrossRef
First
Prev
