Utilization trend of magnetic resonance imaging examinations in an academic emergency department and the weekend effect

Mehmet Cihat Demir 1 * , Yasemin Özdamar 2
More Detail
1 Department of Emergency Medicine, School of Medicine, Düzce University, Düzce, Turkey
2 Department of Emergency Medicine, Manisa City Hospital, Manisa, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 18, Issue 3, pp. 52-57. https://doi.org/10.23950/jcmk/10850
OPEN ACCESS 1867 Views 1121 Downloads
Download Full Text (PDF)

ABSTRACT

Aim: The utilization of magnetic resonance imaging (MRI) in the emergency department (ED) is gradually increasing. An update is needed on how the use of MRI exams in the ED has evolved. To reveal the MRI utilization trends of the ED in the last five years (2015-2019) and whether the weekend effect affects the MRI test requests of the emergency physician.
Methods: ED-ordered MRI examinations were obtained from the hospital’s electronic database retrospectively. MRIs were grouped as abdominopelvic, neuroimaging, musculoskeletal, and others.
Results: A total of 9870 MRI examinations were performed in the 5 years. The rate of ED-ordered MRI tests was 2.65%. MRI for neuroimaging, including brain and spinal examinations, was the most ordered examination, with a rate of 98.8%. The average time between imaging order and acquisition was 46 minutes. No significant difference between the MRI examinations and the weekend effect (p=.121). 25.85% of those who had MRI examinations were hospitalized.
Conclusions: MRI examination for neuroimaging purposes has become an ED routine. Other MRIs are ordered at a nominal rate. The acquisition of an image took an average of 46 minutes. The weekend effect does not affect the decision of the emergency physician to request an MRI examination.
 

CITATION

Demir MC, Özdamar Y. Utilization trend of magnetic resonance imaging examinations in an academic emergency department and the weekend effect. J CLIN MED KAZ. 2021;18(3):52-7. https://doi.org/10.23950/jcmk/10850

REFERENCES

  • Dick EA, Varma D, Kashef E, Curtis J. Use of advanced imaging techniques during visits to emergency departments—implications, costs, patient benefits/risks. Br J Radiol. 2016;89(1061):20150819. doi: 10.1259/bjr.20150819.
  • Quaday KA, Salzman JG, Gordon BD. Magnetic resonance imaging and computed tomography utilization trends in an academic ED. Am J Emerg Med. 2014;32(6):524-528. doi: 10.1016/j.ajem.2014.01.054.
  • Tung M, Sharma R, Hinson JS, Nothelle S, Pannikottu J, Segal JB. Factors associated with imaging overuse in the emergency department: a systematic review. Am J Emerg Med. 2018;36(2):301-309. doi: 10.1016/j.ajem.2017.10.049.
  • Oguz KK, Yousem DM, Deluca T, Herskovits EH, Beauchamp NJ. Effect of emergency department CT on neuroimaging case volume and positive scan rates. Acad Radiol. 2002;9(9):1018-1024. doi: 10.1016/s1076-6332(03)80477-4.
  • Demir MC, Akkas M. Awareness of Risks Associated with the Use of Plain X-Ray, Computed Tomography, and Magnetic Resonance Imaging Among Emergency Physicians and Comparison with that of Other Physicians: A Survey from Turkey. Med Sci Monit. 2019;25:6587-6597. doi: 10.12659/MSM.918381.
  • Korley FK, Pham JC, Kirsch TD. Use of advanced radiology during visits to US emergency departments for injury-related conditions, 1998-2007. JAMA. 2010;304(13):1465-1471. doi: 10.1001/jama.2010.1408.
  • Rankey D, Leach JL, Leach SD. Emergency MRI utilization trends at a tertiary care academic medical center: baseline data. Acad Radiol. 2008;15(4):438-443. doi: 10.1016/j.acra.2008.01.003.
  • Ohana O, Soffer S, Zimlichman E, Klang E. Overuse of CT and MRI in paediatric emergency departments. Br J Radiol. 2018;91(1085):20170434. doi: 10.1259/bjr.20170434.
  • Bell CM, Redelmeier DA. Mortality among patients admitted to hospitals on weekends as compared with weekdays. N Engl J Med. 2001;345(9):663-668. doi: 10.1056/NEJMsa003376.
  • Roberts SE, Thorne K, Akbari A, Samuel DG, Williams JG. Mortality following Stroke, the Weekend Effect and Related Factors: Record Linkage Study. PLoS One. 2015;10(6):e0131836. doi: 10.1371/journal.pone.0131836.
  • Kumar G, Deshmukh A, Sakhuja A, Taneja A, Kumar N, Jacobs E et al. Acute myocardial infarction: a national analysis of the weekend effect over time. J Am Coll Cardiol. 2015;65(2):217-218. doi: 10.1016/j.jacc.2014.09.083.
  • Coleman CI, Brunault RD, Saulsberry WJ. Association between weekend admission and in-hospital mortality for pulmonary embolism: An observational study and meta-analysis. Int J Cardiol. 2015;194:72-74. doi: 10.1016/j.ijcard.2015.05.098.
  • Zapf MA, Kothari AN, Markossian T, Gupta GN, Blackwell RH, Wai PY et al. The "weekend effect" in urgent general operative procedures. Surgery. 2015;158(2):508-514. doi: 10.1016/j.surg.2015.02.024.
  • Somasundram K, Neville JJ, Sinha Y, Agarwal T, Raje D, Sinha A et al. The weekend effect - How can it be mitigated? Introduction of a consultant-delivered emergency general surgical service. Ann Med Surg (Lond). 2020;57:315-320. doi: 10.1016/j.amsu.2020.08.013.
  • Scott JW, Tsai TC, Neiman PU, Jurkovich GJ, Utter GH, Haider AH et al. Lower emergency general surgery (EGS) mortality among hospitals with higher-quality trauma care. J Trauma Acute Care Surg. 2018;84(3):433-440. doi: 10.1097/TA.0000000000001768.
  • Ozdemir BA, Sinha S, Karthikesalingam A, Poloniecki JD, Pearse RM, Grocott MP et al. Mortality of emergency general surgical patients and associations with hospital structures and processes. Br J Anaesth. 2016;116(1):54-62. doi: 10.1093/bja/aev372.
  • Gomez CR. Time is brain: the stroke theory of relativity. J Stroke Cerebrovasc Dis. 2018;27(8):2214-2227. doi: 10.1016/j.jstrokecerebrovasdis.2018.04.001.
  • Gonzalez RG, Schaefer PW, Buonanno FS, Schwamm LH, Budzik RF, Rordorf G et al. Diffusion-weighted MR imaging: diagnostic accuracy in patients imaged within 6 hours of stroke symptom onset. Radiology. 1999;210(1):155-162. doi: 10.1148/radiology.210.1.r99ja02155.
  • Provenzale J. MR imaging of spinal trauma. Emerg Radiol. 2007;13(6):289-297. doi: 10.1007/s10140-006-0568-7.
  • Birbeck GL, Gifford DR, Song J, Belin TR, Mittman BS, Vickrey BG. Do malpractice concerns, payment mechanisms, and attitudes influence test-ordering decisions? Neurology. 2004;62(1):119-121. doi: 10.1212/01.wnl.0000101709.87316.0c.
  • Rozell JM, Li S. Recognition and appropriate use of magnetic resonance imaging for emergent neuroradiology. Semin Ultrasound CT MR. 2017;38(4):424-438. doi: 10.1053/j.sult.2017.02.007.
  • Fehlings MG, Vaccaro A, Wilson JR, Singh A, W Cadotte D, Harrop JS et al. Early versus delayed decompression for traumatic cervical spinal cord injury: results of the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS). PloS one. 2012;7(2):e32037. doi: 10.1371/journal.pone.0032037.
  • Angerer S, Buttinger K, Stummer H. The weekend effect revisited: evidence from the Upper Austrian stroke registry. Eur J Health Econ. 2019;20(5):729-737. doi: 10.1007/s10198-019-01035-4.
  • Aylin P, Yunus A, Bottle A, Majeed A, Bell D. Weekend mortality for emergency admissions. A large, multicentre study. Qual Saf Health Care. 2010;19(3):213-217. doi: 10.1136/qshc.2008.028639.
  • Pauls LA, Johnson-Paben R, McGready J, Murphy JD, Pronovost PJ, Wu CL. The weekend effect in hospitalized patients: a meta-analysis. J Hosp Med. 2017;12(9):760-766. doi: 10.12788/jhm.2815.
  • Jungehulsing G, Rossnagel K, Nolte CH, Muller-Nordhorn J, Roll S et al. Emergency department delays in acute stroke–analysis of time between ED arrival and imaging. Eur J Neurol. 2006;13(3):225-232. doi: 10.1111/j.1468-1331.2006.01170.x.
  • Persky RW, Turtzo LC, McCullough LD. Stroke in women: disparities and outcomes. Curr Cardiol Rep. 2010;12(1):6-13. doi: 10.1007/s11886-009-0080-2.
  • Kocher KE, Meurer WJ, Desmond JS, Nallamothu BK. Effect of testing and treatment on emergency department length of stay using a national database. Acad Emerg Med. 2012;19(5):525-534. doi: 10.1111/j.1553-2712.2012.01353.x.
  • Redd V, Levin S, Toerper M, Creel A, Peterson S. Effects of fully accessible magnetic resonance imaging in the emergency department. Acad Emerg Med. 2015;22(6):741-749. doi: 10.1111/acem.12686.
  • Ditkofsky NG, Singh A, Avery L, Novelline RA. The role of emergency MRI in the setting of acute abdominal pain. Emerg Radiol. 2014;21(6):615-624. doi: 10.1007/s10140-014-1232-2.
  • Peery AF, Dellon ES, Lund J, Crockett SD, McGowan CE, Bulsiewicz WJ et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012;143(5):1179-1187.e3. doi: 10.1053/j.gastro.2012.08.002.
  • Stoker J. Magnetic resonance imaging and the acute abdomen. Br J Surg. 2008;95(10):1193-1194. doi: 10.1002/bjs.6378.
  • Mehta P, Morrow M, Russell J, Madhuripan N, Habeeb M. Magnetic resonance imaging of musculoskeletal emergencies. Semin Ultrasound CT MR. 2017;38(4):439-452. doi: 10.1053/j.sult.2017.04.001.
  • Cournane S, Creagh D, O'Hare N, Sheehy N, Silke B. MRI in acutely ill medical patients in an Irish hospital: influence on outcomes and length of hospital stay. J Am Coll Radiol. 2014;11(7):698-702. doi: 10.1016/j.jacr.2014.01.014.