0 226

Cited 5 times in

Predictors of Urgent Findings on Abdominopelvic CT in Patients with Crohn's Disease Presenting to the Emergency Department

 Yoon Suk Jung  ;  Dong Il Park  ;  Sung Noh Hong  ;  Eun Ran Kim  ;  Young Ho Kim  ;  Jae Hee Cheon  ;  Chang Soo Eun  ;  Dong Soo Han  ;  Chang Kyun Lee  ;  Jae Hak Kim  ;  Kyu Chan Huh  ;  Soon Man Yoon  ;  Hyun Joo Song  ;  Jeong Eun Shin  ;  Seong Ran Jeon 
 DIGESTIVE DISEASES AND SCIENCES, Vol.60(4) : 929-935, 2015 
Journal Title
Issue Date
Abdominal Abscess/diagnostic imaging ; Abdominal Abscess/epidemiology ; Abdominal Abscess/etiology* ; Adolescent ; Adult ; Crohn Disease/complications* ; Crohn Disease/diagnostic imaging* ; Emergency Service, Hospital/statistics & numerical data ; Female ; Humans ; Intestinal Obstruction/diagnostic imaging ; Intestinal Obstruction/epidemiology ; Intestinal Obstruction/etiology* ; Intestinal Perforation/diagnostic imaging ; Intestinal Perforation/epidemiology ; Intestinal Perforation/etiology* ; Male ; Republic of Korea/epidemiology ; Retrospective Studies ; Tomography, X-Ray Computed/statistics & numerical data ; Young Adult
Crohn’s disease ; Computed tomography ; Emergency department ; Urgent finding
BACKGROUND: Patients with Crohn's disease (CD) are frequently exposed to diagnostic radiation, mainly as a result of abdominopelvic computed tomography (APCT) examinations. However, there are limited data on the impact of APCT on clinical management in this population. AIM: To investigate clinical predictors of urgent findings on APCT in patients with CD who presented to the emergency department (ED). METHODS: A retrospective study was performed among patients with CD presenting to 11 EDs with a gastrointestinal complaint. The primary outcome, OPAN (obstruction, perforation, abscess, or non-CD-related urgent findings), included new or worsening CD-related urgent findings or non-CD-related urgent findings that required urgent or emergency treatment. Variables with P < 0.1 in univariate analyses were included in a multivariable logistic regression model. RESULTS: Of the 266 APCTs performed, 103 (38.7 %) had OPAN and 113 (42.5 %) required changes in treatment plan. Stricturing or penetrating disease (odds ratio [OR] 2.72, 95 % confidence interval [CI] 1.21-6.13), heart rate >100 beats/min (OR 2.33, 95 % CI 1.10-4.93), leukocyte count >10,000/mm(3) (OR 4.38, 95 % CI 2.10-9.13), and CRP >2.5 mg/dL (OR 3.11, 95 % CI 1.23-7.86) were identified as the independent predictors of OPAN, whereas biologic agent use (OR 0.37; 95 % CI 0.15-0.90) was identified as the negative predictor in patients with CD. CONCLUSIONS: Only 39 % of the APCTs performed in the ED among patients with CD showed urgent findings. Stricturing or penetrating disease, tachycardia, leukocytosis, and high CRP level were predictors of urgent CT findings, while biologic agent use was a negative predictor. To reduce unnecessary radiation exposure, the selection process for CD patients referred for APCT must be improved.
Full Text
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
사서에게 알리기


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.