Abstract：
BACKGROUND: The use of abdominal radiography (AXR) apparently continues to be widespread despite its limited indications, the potential radiation and unnecessary costs associated. In addition, the interpretation and its report seem variable and not always performed by a radiologist. Our objective is to analyze the use, adequacy and usefulness of AXR in the emergency of a tertiary referral hospital.
METHODS: We retrospectively reviewed all the AXR performed in January 2020 in the emergency of our centre, as well as the patient\'s demographics and medical records, technical quality of the radiographs, indications according to the SERAM (Spanish Society of Radiology) Appropriateness Guidelines, presence of a formal radiology report, and impact on the clinical management of the patient. Of all non-appropriated AXR we calculated the radiation received by the patients and its extra costs.
RESULTS: In January 2020, 429 AXR (9.1% of all radiographies) were performed in the emergency of our centre. The most frequent indication was abdominal pain (40%, n = 176), followed by low back pain (21.4%, n = 92). 12.4% of AXR requested did not include any clinical information. Most of the AXR (79.6%) had sufficient technical quality. 61.3% (n = 263) of the AXR performed were not indicated, assuming an average unjustified radiation dose per patient of 0.50 ± 0.33 mSv, and a total additional cost of 6575;. Only 6% of the inadequate AXRs led to a change in the clinical management of the patient, compared to 29% of the adequate AXR (p < 0.001). Only 3% of the AXR had a formal radiology report.
CONCLUSIONS: AXR is still common in the emergency setting, although most of them might be inadequate according to the SERAM Appropriateness Guidelines. Its use should be optimized to avoid unnecessary radiation and costs. Radiologists must have a more active participation in the management of AXR.
METHODS: We retrospectively reviewed all the AXR performed in January 2020 in the emergency of our centre, as well as the patient\'s demographics and medical records, technical quality of the radiographs, indications according to the SERAM (Spanish Society of Radiology) Appropriateness Guidelines, presence of a formal radiology report, and impact on the clinical management of the patient. Of all non-appropriated AXR we calculated the radiation received by the patients and its extra costs.
RESULTS: In January 2020, 429 AXR (9.1% of all radiographies) were performed in the emergency of our centre. The most frequent indication was abdominal pain (40%, n = 176), followed by low back pain (21.4%, n = 92). 12.4% of AXR requested did not include any clinical information. Most of the AXR (79.6%) had sufficient technical quality. 61.3% (n = 263) of the AXR performed were not indicated, assuming an average unjustified radiation dose per patient of 0.50 ± 0.33 mSv, and a total additional cost of 6575;. Only 6% of the inadequate AXRs led to a change in the clinical management of the patient, compared to 29% of the adequate AXR (p < 0.001). Only 3% of the AXR had a formal radiology report.
CONCLUSIONS: AXR is still common in the emergency setting, although most of them might be inadequate according to the SERAM Appropriateness Guidelines. Its use should be optimized to avoid unnecessary radiation and costs. Radiologists must have a more active participation in the management of AXR.
摘要：
背景：尽管其适应症有限，但腹部X线片（AXR）的使用显然仍然很普遍，潜在的辐射和不必要的成本。此外,解释及其报告似乎是可变的，并不总是由放射科医师执行。我们的目标是分析使用，AXR在三级转诊医院急诊中的充分性和实用性。
方法：我们回顾性回顾了2020年1月在我们中心的紧急情况下进行的所有AXR，以及病人的人口统计和医疗记录，射线照片的技术质量，根据SERAM（西班牙放射学会）适当性指南，有正式的放射学报告，以及对患者临床管理的影响。在所有未分配的AXR中，我们计算了患者接受的辐射及其额外费用。
结果：2020年1月，在我们中心的紧急情况下进行了429次AXR（占所有X光检查的9.1％）。最常见的适应症是腹痛（40％，n=176),其次是腰痛(21.4%，n=92）。12.4%的AXR请求不包括任何临床信息。大多数AXR（79.6％）具有足够的技术质量。61.3%(n=263)的AXR没有显示，假设每位患者的平均不合理辐射剂量为0.50±0.33mSv，和总额外费用6575；。只有6%的不足的AXR导致了患者临床管理的变化，与29%的适当AXR(p<0.001)相比。只有3%的AXR有正式的放射学报告。
结论：AXR在紧急情况下仍然很常见，尽管根据SERAM适当性指南，其中大多数可能不足。应优化其使用，以避免不必要的辐射和成本。放射科医生必须更积极地参与AXR的管理。
方法：我们回顾性回顾了2020年1月在我们中心的紧急情况下进行的所有AXR，以及病人的人口统计和医疗记录，射线照片的技术质量，根据SERAM（西班牙放射学会）适当性指南，有正式的放射学报告，以及对患者临床管理的影响。在所有未分配的AXR中，我们计算了患者接受的辐射及其额外费用。
结果：2020年1月，在我们中心的紧急情况下进行了429次AXR（占所有X光检查的9.1％）。最常见的适应症是腹痛（40％，n=176),其次是腰痛(21.4%，n=92）。12.4%的AXR请求不包括任何临床信息。大多数AXR（79.6％）具有足够的技术质量。61.3%(n=263)的AXR没有显示，假设每位患者的平均不合理辐射剂量为0.50±0.33mSv，和总额外费用6575；。只有6%的不足的AXR导致了患者临床管理的变化，与29%的适当AXR(p<0.001)相比。只有3%的AXR有正式的放射学报告。
结论：AXR在紧急情况下仍然很常见，尽管根据SERAM适当性指南，其中大多数可能不足。应优化其使用，以避免不必要的辐射和成本。放射科医生必须更积极地参与AXR的管理。
