SSQ17-06

Pediatric MRI in the Emergency Department Over Five Years: An Analysis of Usage and Trends

Thursday, Dec. 1 11:20AM - 11:30AM Room: S102C



Participants
Miriam Hulkower, MD, Bronx, NY (Presenter) Nothing to Disclose
Benjamin Taragin, MD, Teaneck, NJ (Abstract Co-Author) Medical Advisory Board, Carestream Health, Inc
Reubin Davoudzadeh, MD, Bronx, NY (Abstract Co-Author) Nothing to Disclose
Dan Wang, Bronx, NY (Abstract Co-Author) Nothing to Disclose
Tao Wang, MD,PhD, Bronx, NY (Abstract Co-Author) Nothing to Disclose
Meir H. Scheinfeld, MD, PhD, Bronx, NY (Abstract Co-Author) Nothing to Disclose
Michele J. Fagan, MD, Bronx, NY (Abstract Co-Author) Nothing to Disclose

PURPOSE

Our institution as well as others have added 24/7 MRI availability for Pediatric Emergency Department (PED) patients. Our purpose was to evaluate MRI usage and trends among pediatric patients.

METHOD AND MATERIALS

IRB exemption was obtained. All MRI exams performed on PED patients from 2011 through 2015 were tabulated along with demographic data. PED triage volume data were also obtained to normalize MRI data. The z-test was used to compare MRI utilization in male and female patients. A Chi-squared test for trend in proportions was used to test for a trend in usage over the five year period. MRI utilization per ED visit versus patient age was tabulated and confidence intervals were calculated. MRI usage for each hour of the day was plotted to determine the hours with the highest volume.

RESULTS

There were a total of 997 MRI exams and 561,704 triages performed over the five year period. Regarding category of MRI exam, 57% were of the brain, 15% were of the spine, 13% were neurologic MRA exams, 6% were of the abdomen, 5% were of the face, 4% were musculoskeletal and 0.3% were of the chest. There was significantly higher MRI utilization for females (MRI performed during 0.21% of ED visits) compared to males (MRI performed during 0.14% of ED visits, p<0.001). There was a statistically significant increasing utilization trend over the five year period (p<0.001) with MRI being performed during 0.12% of visits in 2011 and 0.24% of visits during 2015. Utilization generally increased with patient age, with lowest utilization in 3 year olds (MRI during 0.0053% of visits) and highest utilization in 17 year olds (MRI during 0.54% of visits). Highest PED MRI volume was during the evening and early nighttime hours with peak volume occurring during the 10 PM hour when 8.2% of MRI exams were performed.

CONCLUSION

The most common exams performed in the PED were neurological. Utilization was higher in girls and in older children. Utilization progressively increased over the study period. Evening and early nighttime hours saw the greatest MRI usage. 

CLINICAL RELEVANCE/APPLICATION

The data presented demonstrates that there is increasing PED MRI utilization, particularly of neurological studies, suggesting that off-hour resource availability during the evening and early nighttime hours would be well utilized.