Does shifting to professional emergency department staffing affect the decision for chest radiography?  

作　　者：Marin Pavlov Lucija Klobucar Iva Klobučar Kristinazgela Vesna Degoricija 

机构地区：[1]Department of Cardiology,Sestre Milosrdnice University Hospital Centre,Zagreb 10000,Croatia [2]Institute of Emergency Medicine,Osijek-Baranja County,Osijek 31000,Croatia [3]University of Zagreb School of Medicine,Zagreb 10000,Croatia [4]Department of Medicine,Sestre milosrdnice University Hospital Centre,Zagreb 10000,Croatia

出　　处：《World Journal of Emergency Medicine》2021年第2期87-92,共6页世界急诊医学杂志（英文）

摘　　要：BACKGROUND: The study aims to determine whether shifting to professional emergency department(ED) teams leads to a higher rate of radiologic workup.METHODS: We retrospectively analyzed a total of 2,000 patients presenting to the ED of a tertiary teaching hospital in two time periods: group 1(G1) comprised 1,000 consecutive patients enrolled from December 21, 2012 to January 5, 2013(all patients were examined by an internal medicine specialist);group 2(G2) comprised 1,000 consecutive patients enrolled from December 21, 2018 to January 3, 2019(all patients were examined by an emergency physician).RESULTS: The chest X-ray(CXR) was performed in 40.6% of all patients. There was no difference in the frequency of CXR(38.9% in G1 vs. 42.3% in G2, P=0.152). More CXRs were performed in G2 patients older than 65 years, in female patients older than 65 years, in patients presenting during the evening and night shifts or off-hours, in patients with a history of malignancy, in patients with gastrointestinal bleeding, and in patients with bradycardia, but fewer in patients presenting with arrhythmia. No difference in the rates of pathological CXR was found(47.3% in G1 vs. 52.2% in G2, P=0.186). Compared with G2, higher sensitivity and specificity were obtained for the binary logistic regression model predicting pathological findings in G1.CONCLUSIONS: Shifting to professional ED teams does not increase radiologic workup. By implementing deliberate usage of ultrasound, some self-governing procedures, case-oriented investigations, and center-specific recommendations, unnecessary radiologic workup can be avoided. Professional ED teams could lead to a higher standard of emergency care.

关 键 词：Chest radiography Emergency department Emergency physicians Healthcare organization 

分 类 号：R816[医药卫生—放射医学]