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

World Journal of Emergency Medicine 2021年第2期12卷 87-92页

作者： Marin Pavlov Lucija Klobucar Iva Klobučar Kristinazgela Vesna Degoricija Department of Cardiology Sestre Milosrdnice University Hospital CentreZagreb 10000Croatia Institute of Emergency Medicine Osijek-Baranja CountyOsijek 31000Croatia University of Zagreb School of Medicine Zagreb 10000Croatia Department of Medicine Sestre milosrdnice University Hospital CentreZagreb 10000Croatia

BACKGROUND: The study aims to determine whether shifting to professional emergency department(ED) teams leads to a higher rate of radiologic ***: 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 ***: 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

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