Emergency Radiology

, Volume 25, Issue 4, pp 393–398 | Cite as

Clinical impact of computed tomography in the emergency department in nontraumatic chest and abdominal conditions

  • Lorenzo Carlo Pescatori
  • Matteo Brambati
  • Carmelo Messina
  • Giovanni Mauri
  • Giovanni Di Leo
  • Enzo Silvestri
  • Francesco Sardanelli
  • Luca Maria Sconfienza
Original Article



To evaluate the clinical impact of CT scan in modifying the clinical management in patients referred to the emergency department.


We prospectively evaluated 300 patients (177 males, 63 ± 18 years old) admitted in the emergency department (ED) of a single institution, who underwent a CT examination for thoracic and/or abdominal complains. Demographic and clinical data were collected. Hypothesized outcome prior to CT scan and final management (i.e., discharge, short observation in the ED, hospitalization, and department of admission) were compared.


After CT examination, a major variation in diagnosis occurred in 37% of cases and clinical management changed in 43%, occurring in 51% of patients who underwent abdominal CT, in 40% of chest CT, and in 29% of chest/abdominal CT (P = 0.015). Department of hospitalization changed in 26% of cases (P < 0.001). Clinical impact of CT scan was significantly associated (P = 0.001) with the color code at admission. In particular, the more severe was the clinical condition, the lower was the variation of management after CT examination.


This work confirms the crucial role of CT examination in the management of nontraumatic patients admitted to the ED, both in terms of better clarifying the diagnosis and in influencing the clinical management.


Computed tomography Emergency department Clinical impact Outcome 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was waived by the relevant Ethics Committee.


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Copyright information

© American Society of Emergency Radiology 2018

Authors and Affiliations

  • Lorenzo Carlo Pescatori
    • 1
  • Matteo Brambati
    • 2
  • Carmelo Messina
    • 3
  • Giovanni Mauri
    • 4
  • Giovanni Di Leo
    • 5
  • Enzo Silvestri
    • 6
  • Francesco Sardanelli
    • 5
    • 7
  • Luca Maria Sconfienza
    • 3
    • 7
  1. 1.Scuola di Specializzazione in RadiodiagnosticaUniversità degli Studi di MilanoMilanItaly
  2. 2.Dipartimento di Biotecnologie e Scienze della VitaUniversità degli Studi dell’InsubriaVareseItaly
  3. 3.Unità Operativa di Radiologia / Diagnostica per Immagini con Servizio di Radiologia InterventisticaIRCCS Istituto Ortopedico GaleazziMilanItaly
  4. 4.Dipartimento di Radiologia InterventisticaIstituto Europeo di OncologiaMilanItaly
  5. 5.Unità di RadiologiaIRCCS Policlinico San DonatoMilanItaly
  6. 6.Servizio di RadiologiaOspedale Evangelico InternazionaleGenovaItaly
  7. 7.Dipartimento di Scienze Biomediche per la SaluteUniversità degli Studi di MilanoMilanItaly

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