Motta-Ramírez GA, Martínez-Luján E

Language: Spanish
References: 0
Page: 147-177
PDF size: 1308.61 Kb.

ABSTRACT

Purpose: determine the correlation, or diagnostic congruence, between clinical diagnosis at a patient’s admission to this hospital’s adult emergency ward and diagnosis by abdominopelvic computerized tomography with intravenous contrast medium in a 12-month retrospective observation period.
Material and Methods: we verified all abdominopelvic tomographies with intravenous contrast medium taken on patients attended in the hospital’s adult emergency ward for non-traumatic acute abdominal pain syndrome, in the period from October 2013 through October 2014, supported by Centricity^® RIS 4.1i plus software, which was used to analyze radiological reports on the studies in question and their results, in order to identify cases in which this imaging method confirmed the clinical diagnosis established in the adult emergency ward; also, each patient’s transoperative results were obtained by consulting their electronic clinical records (for those who underwent surgery) and, as deemed necessary, laboratory results for further, complementary confirmation.
Results: our sample consisted of 357 abdominopelvic tomographies with intravenous contrast medium taken on the same number of patients who satisfied the inclusion criteria and who sought medical attention in the hospital’s emergency ward for non-traumatic acute abdominal pain syndrome over a 12-month period. Of this number of patients, only 68% of medical orders specified a presumptive nosological diagnosis; in the remaining 32% of tomography orders, the clinical information was limited to “abdominal pain under study.” Of the cases analyzed in this study following the sequence: clinical suspicion or diagnosis, abdominopelvic tomography with intravenous contrast medium, and transoperative or laboratory confirmation, 88% consisted of diagnoses such as acute appendicitis, intestinal blockage, pancreatitis, and diverticular disease, which are among the 15 leading causes of morbidity in the population admitted to our facility, as reported in the statistical yearbooks for 2012 and 2013.
Conclusions: the congruence between the diagnosis obtained by means of questioning/physical exploration and abdominopelvic tomography with intravenous contrast medium was 26.6% (in other words, there was clinical radiological diagnostic congruence in 95 of 357 patients). Classifying this clinical radiological correlation in relative terms, based on the most common pathologies found in the study population, the percentage of clinical radiological diagnostic congruence varies between 41.8% (in the case of pancreatitis) and 52.6% (in the case of intestinal blockage), findings which coincide with those reported in the literature in Mexico.