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Nationwide Trends in Imaging Utilization During the Emergency Department Evaluation of Flank Pain, 2000-2008
Elias Hyams1, Frederick Korley2, Brian Matlaga1
1Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, MD;2Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD
Introduction: Patients with acute flank pain are most commonly evaluated in the emergency department (ED) with computed tomography (CT). At present, however, our understanding of radiographic practice patterns in the emergency evaluation of flank pain is limited. Therefore, we performed a study to characterize the utilization of conventional radiography (CR), ultrasound (US), and CT in the ED evaluation of patients with acute flank pain.
Materials and Methods: A retrospective cross-sectional analysis of ED visits using data from the National Hospital Ambulatory Medical Care Survey (2000-2008) was performed. Specific visits for a complaint of either flank pain or kidney pain were further analyzed.
Results: Over the time period studied, there was a significant increase in the utilization of CT (p<0.0001), a significant decline in the use of CR (p=0.0156), and the utilization of US remained stable (p=0.3012). Over that same time period, the proportion of patients with flank pain who were diagnosed with a kidney stone remained stable, at approximately 20% (p=0.4441).
Conclusion: Between 2000 and 2008, there was a significant increase in the utilization of CT in the emergency evaluation of CT utilization, but the proportion of patients with flank pain who were diagnosed with a kidney stone remained stable.
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