caa a22 4500 605493588 CHVBK 20210128100521.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00261-015-0419-7 doi (NATIONALLICENCE)springer-10.1007/s00261-015-0419-7 Impact of CT in elderly patients presenting to the emergency department with acute abdominal pain [Elektronische Daten] [Carly Gardner, Tracy Jaffe, Rendon Nelson] Purpose: The purpose of the study was to document the clinical impact of CT in elderly patients presenting to the emergency department (ED) with abdominal pain. Methods: This retrospective IRB-approved study from 2006 to 2013 evaluated 464 patients ≥80years (mean 89years, range 80-100: M150, W314), who presented to the ED with acute abdominal symptoms and underwent CT. CTs were divided into those negative and positive for actionable findings, defined as potentially requiring a change in surgical or medical management. Physician diagnosis, treatment plan, and disposition before and after CT were reviewed in the electronic medical record to assess CT influence on management and disposition. CT diagnosis was confirmed with final clinical diagnosis, surgical intervention, pathology, and follow-up. Descriptive statistics were used. Results: CTs were positive in 55%. The most common diagnoses were SBO (18%), diverticulitis (9%), non-ischemic vascular-related emergency (6%), bowel ischemia (4%), appendicitis (3%), and colonic obstruction (2%). These diagnoses were clinically unsuspected prior to CT in 43% (p<0.05), with significant difficultly in diagnosing SBO (p<0.05), diverticulitis (p<0.01), and colonic obstruction (p<0.01). Positive CT results influenced treatment plans in 65%, surgical in 48%, and medical in 52%. Disposition from the ED was significantly affected by CT (p<0.001), 65% of admissions with positive CT (p<0.001) and 63% of discharges with negative CT (p<0.001). Conclusion: Utilization of abdominopelvic CT in geriatric patients presenting to the ED with acute abdominal symptoms strongly influences clinical management and significantly affects disposition. As the US population ages, the clinical impact of emergent CT in the elderly will intensify. Springer Science+Business Media New York, 2015 Abdominal pain nationallicence CT nationallicence Emergency department nationallicence Elderly nationallicence Gardner Carly The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, 77030-4009, Houston, TX, USA aut Jaffe Tracy Duke University Medical Center, 2301 Erwin Road, Box 3808, 27710, Durham, NC, USA aut Nelson Rendon Duke University Medical Center, 2301 Erwin Road, Box 3808, 27710, Durham, NC, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2877-2882 0942-8925 40:7<2877 2015 40 261 https://doi.org/10.1007/s00261-015-0419-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-015-0419-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Gardner Carly The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, 77030-4009, Houston, TX, USA aut NATIONALLICENCE 700 1- Jaffe Tracy Duke University Medical Center, 2301 Erwin Road, Box 3808, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Nelson Rendon Duke University Medical Center, 2301 Erwin Road, Box 3808, 27710, Durham, NC, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2877-2882 0942-8925 40:7<2877 2015 40 261