Can lab data be used to reduce abdominal computed tomography (CT) usage in young adults presenting to the emergency department with nontraumatic abdominal pain?

Meir H. Scheinfeld, Soham Mahadevia, Evan G. Stein, Katherine Freeman, Alla Rozenblit

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

We sought to determine whether laboratory parameters could be found, predictive of a negative abdominal CT scan in young adults with nontraumatic abdominal pain. Following institutional review board approval, we evaluated CT reports of 522 patients, aged 21-35 years old, who presented to the Emergency Department with nontraumatic abdominal pain. Bivariate analyses relating ten laboratory parameters to whether the CT detected a cause for abdominal pain were conducted. A multivariate logistic regression model was then derived, with all variables in the final model significant at p<0.05. Variables were dichotomized to yield odds ratios and 95% confidence intervals. Of the 522 patients meeting inclusion criteria, 45% had a cause for pain demonstrated by CT. Predictors of a negative CT in men were normal hematocrit and negative urine blood (p=0.045, p=0.016, respectively), and in women normal hematocrit, granulocyte percent, and alkaline phosphatase (p=0.023, p=0.039, p<0.0001, respectively). When standard normal values were used to calculate descriptive statistics, only granulocyte percent in women had a significant confidence interval (odds ratio 2.5, confidence interval 1.6-4.0). Among the 208 women with normal granulocyte percent, the final clinical diagnosis was appendicitis, cholecystitis, and diverticulitis, in three, three, and two cases, respectively (4% combined). In summary, no laboratory test was sufficient to offer reassurance that a CT is not necessary in a young adult patient with nontraumatic abdominal pain. Alternative strategies should be considered to decrease the use of CT, and its associated radiation exposure, in young adults with nontraumatic abdominal pain.

Original languageEnglish (US)
Pages (from-to)353-360
Number of pages8
JournalEmergency Radiology
Volume17
Issue number5
DOIs
StatePublished - Sep 2010

Fingerprint

Abdominal Pain
Hospital Emergency Service
Young Adult
Tomography
Granulocytes
Confidence Intervals
Hematocrit
Logistic Models
Odds Ratio
Diverticulitis
Cholecystitis
Research Ethics Committees
Appendicitis
Alkaline Phosphatase
Reference Values
Urine
Pain

Keywords

  • Abdominal pain
  • CT
  • Emergency department
  • Laboratory data
  • Nontraumatic

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Emergency Medicine

Cite this

Can lab data be used to reduce abdominal computed tomography (CT) usage in young adults presenting to the emergency department with nontraumatic abdominal pain? / Scheinfeld, Meir H.; Mahadevia, Soham; Stein, Evan G.; Freeman, Katherine; Rozenblit, Alla.

In: Emergency Radiology, Vol. 17, No. 5, 09.2010, p. 353-360.

Research output: Contribution to journalArticle

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