Prospective audit of cross-sectional imaging and radiation exposure in general surgical patients

Ann R Coll Surg Engl. 2011 Jan;93(1):6-8. doi: 10.1308/003588411X12851639107197. Epub 2010 Oct 15.

Abstract

Introduction: Most patients admitted with an acute surgical problem undergo some imaging during their in-patient stay. As computed tomography (CT) scanning becomes more readily available, it is becoming the mainstay of assessment. Recent studies have commented on the potential adverse effects of early cross-sectional imaging. This audit aimed to determine the use of early cross-sectional imaging and associated radiation dose in an acute surgical cohort.

Patients and methods: Data from 500 acute surgical patients were prospectively collected over a 3-month period. CT scans were undertaken, the effect on subsequent diagnostic and management decisions and the potential associated risks were evaluated.

Results: Almost 40% of subjects underwent CT scanning. Of these, 20% did not alter management and could be deemed unnecessary. The radiation exposure equated to an age- and gender-specific risk of fatal cancer induction between 1 in 1675 and 1 in 7130.

Conclusions: Early-cross sectional imaging provides a valuable diagnostic adjunct. Decisions to expose patients to potentially hazardous radiation need to acknowledge the anticipated benefits versus risks.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Epidemiologic Methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms, Radiation-Induced / etiology*
  • Neoplasms, Radiation-Induced / mortality
  • Radiation Dosage*
  • Risk Assessment
  • Tomography, X-Ray Computed / adverse effects*
  • Young Adult