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Impact of routine contrast-enhanced CT on costs and use of hospital resources in patients with acute abdomen. Results of a randomised clinical trial

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Abstract

Objectives

To evaluate the costs of treatment and use of hospital resources when comparing routine abdominal CT and selective imaging practice based on clinical assessment in patients with acute abdomen.

Methods

Altogether 300 patients with acute abdominal pain were randomised to computed tomography (CT, n = 150) or selective imaging practice (SIP, n = 150) groups. Final analysis included 254 patients, 143 in the CT and 111 in the SIP group. All CT group patients underwent contrast-enhanced abdominal CT within 24 h of admission. In the SIP group, imaging was individually tailored based on clinical assessment. The numbers of various examinations and procedures as well as costs of treatment arising from acute abdomen were calculated for each patient. Length of hospital stay was registered.

Results

Total treatment cost per patient was 1,202 euros (€) higher in the CT group compared to the SIP group (P = 0.002). The length of hospital stay was 1.2 days longer in the CT group (3.7 vs. 2.5 days, P = 0.010). Routine CT had no impact on ED discharge times. Imaging costs accounted for approximately 10 % of total costs.

Conclusion

Routine abdominal CT results in higher treatment costs compared to selective use of imaging in patients with acute abdomen.

Key Points

• CT is widely used almost routinely in the diagnostics of acute abdomen.

• Patients with acute abdomen were randomised to routine CT or selective imaging.

• The treatment costs were significantly higher in the routine CT group.

• Length of hospital stay was longer in the CT group.

• Selective use of imaging may help control continuous increases of treatment costs.

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Abbreviations

ED:

emergency department

ICD-10:

International Statistical Classification of Diseases and Related Health Problems, 10th revision

ICU:

intensive care unit

NSAP:

non-specific abdominal pain

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Acknowledgments

This study was funded by the Kuopio University Hospital EVO funding (grant no. 5200617).

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Authors and Affiliations

  1. Department of Clinical Radiology, Kuopio University Hospital, P.O. Box 1777, FI-70211, Kuopio, Finland

    Tiina Lehtimäki & Ritva Vanninen

  2. Gastrointestinal Surgery, Kuopio University Hospital, P.O. Box 1777, FI-70211, Kuopio, Finland

    Petri Juvonen, Pekka Miettinen & Hannu Paajanen

  3. Department of Clinical Medicine, Unit of Radiology, University of Eastern Finland, Kuopio, Finland

    Ritva Vanninen

  4. Department of Clinical Medicine, Unit of Surgery, University of Eastern Finland, Kuopio, Finland

    Hannu Paajanen

  5. Department of Health and Social Management, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland

    Hannu Valtonen

Authors
  1. Tiina Lehtimäki
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  2. Petri Juvonen
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  3. Hannu Valtonen
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  4. Pekka Miettinen
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  5. Hannu Paajanen
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  6. Ritva Vanninen
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Correspondence to Tiina Lehtimäki.

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Lehtimäki, T., Juvonen, P., Valtonen, H. et al. Impact of routine contrast-enhanced CT on costs and use of hospital resources in patients with acute abdomen. Results of a randomised clinical trial. Eur Radiol 23, 2538–2545 (2013). https://doi.org/10.1007/s00330-013-2848-4

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  • DOI: https://doi.org/10.1007/s00330-013-2848-4

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