Impact of the COVID-19 pandemic on emergency department CT for suspected diverticulitis
Department of Radiology
Diagnosis | Digestive System Diseases | Emergency Medicine | Health Services Administration | Infectious Disease | Radiology | Virus Diseases
PURPOSE: This study examined the impact of the COVID-19 pandemic on emergency department CT use for acute nontraumatic abdominal pain, to better understand why imaging volume so drastically decreased during the COVID-19 pandemic.
METHODS: This was a retrospective review of emergency imaging volumes from January 5 to May 30, 2020. Weekly volume data were collected for total imaging studies, abdominopelvic CT, and abdominopelvic CTs positive for common causes of acute nontraumatic abdominal pain. Two emergency radiology attendings scored all diverticulitis cases independently, and weekly volume data for uncomplicated and complicated diverticulitis cases was also collected. Volume data prior to and during the COVID-19 pandemic was compared, using 2019 volumes as a control.
RESULTS: During the COVID-19 pandemic, overall emergency imaging volume decreased 30% compared to 2019 (p = 0.002). While the number of emergency abdominopelvic CTs positive for appendicitis and small bowel obstruction did not significantly change during the COVID-19 pandemic, the number of cases of diverticulitis decreased significantly compared to 2019 (p = 0.001). This reduction can be specifically attributed to decreased uncomplicated diverticulitis cases, as the number of uncomplicated diverticulitis cases dropped significantly (p = 0.002) while there was no significant difference in the number of complicated diverticulitis cases (p = 0.09).
CONCLUSIONS: Reduced emergency abdominopelvic CT volume during the COVID-19 pandemic can partially be explained by decreased imaging of lower acuity patients. This data may help formulate future strategies for imaging resource utilization with an improved understanding of the relationship between perceived imaging risk and symptom acuity.
COVID-19, CT Utilization, Abdominopelvic CT, Diverticulitis, emergency department, imaging volume
DOI of Published Version
Gibson AL, Chen BY, Rosen MP, Paez SN, Lo HS. Impact of the COVID-19 pandemic on emergency department CT for suspected diverticulitis. Emerg Radiol. 2020 Dec;27(6):773-780. doi: 10.1007/s10140-020-01865-3. Epub 2020 Oct 28. PMID: 33111154; PMCID: PMC7591272. Link to article on publisher's site
Gibson AL, Chen BY, Rosen MP, Paez SN, Lo HS. (2020). Impact of the COVID-19 pandemic on emergency department CT for suspected diverticulitis. COVID-19 Publications by UMMS Authors. https://doi.org/10.1007/s10140-020-01865-3. Retrieved from https://escholarship.umassmed.edu/covid19/149