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 between 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 top 5 clinical chief complaints for all patients receiving an MRI were also reported. 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 a mean increase of 2 MRI per 1000 ED encounters between 2007 - 2011, with a mean decrease of 12 CT per 1,000 encounters over the same time period. 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, unknown, trauma, extremity pain, and neck/back pain. Conclusion: The rate of MRI utilization has increased by 2 per 1,000 ED encounters over 5 years, while the rate of CT use has decreased over the same time period. Determining the reasons for increased MRI use is worthy of further study.