A retrospective descriptive study of MRI use in an academic emergency department [poster]
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Background: The high rate of computed tomography (CT) use over the last decade has resulted in concerns about radiation exposure and healthcare costs. MRI offers excellent visualization of most organs without radiation and may be an alternative to CT for many emergency patients. To date, limited work has been done to evaluate the use of MRI on patients seen in the emergency department (ED). Methods: This is a retrospective observational study describing the utilization trends of MRI in an emergency department at a single urban academic hospital from 2007-2011. Descriptive data on institutional volume metrics were calculated, including the rate of CT utilization over the same time period. The normalized annual usage of MRI (per 1,000 visits) for 2007-2011 were calculated, as was the percent of all patients per year receiving MRI at our institution. The most frequently completed MRIs were reported, as were the top 5 clinical chief complaints for all patients receiving an MRI. Results: Over the 5 year study period, a total of 85,831 CT (241 per 1000 encounters) and 7,177 MRI (20 per 1,000 encounters) were performed in the ED. There was an average yearly increase of 2 MRIs per 1000 ED encounters from 2007 2011, with an overall increase of 8.6 MRIs per 1000 encounters (36% relative increase). During this time, there was an average yearly decrease of 12 CTs per 1,000 encounters, with an overall decrease of 48.9 CTs per 1000 encounters (19% relative decrease). MRI head were ordered most frequently (10.7 per 1,000), followed by MRA neck (2.9 per 1,000), MRI lumbar spine (2.2 per 1,000), MRI cervical spine (2.0 per 1,000), and MRI extremity (0.82 per 1,000). The top 5 chief complaints for patients receiving any MRI included acute neurological / behavioral problem, trauma, extremity pain, neck/back pain, and weakness. Conclusion: The rate of MRI utilization has increased at our institution during the study period, with a simultaneous decrease in the rate of CT use. Determining the reasons for increased MRI use is worthy of further study.