RESUMEN:
Introducción: El papel de la tomografía computarizada torácica de ultra baja dosis (ULDCT) en un contexto de urgencia es desconocido. Objetivo: Este estudio evaluó la viabilidad de la ULDCT en adultos en urgencias con sospecha de neumonía. Se midieron la dosis de radiación, el tiempo entre la solicitud y los informes del examen, y también se correlacionaron las prescripciones de antimicrobianos. Métodos: Este estudio evaluó la viabilidad de la ULDCT en adultos en urgencias con sospecha de neumonía. Se midieron la dosis de radiación, el tiempo entre la solicitud y la disponibilidad de los informes del examen, y también se correlacionaron las prescripciones de antimicrobianos. Entre octubre de 2017 y diciembre de 2018, incluimos prospectivamente a adultos con sospecha de neumonía adquirida en la comunidad, sin diagnóstico definitivo por evaluación clínica. Los criterios de exclusión abarcaron condiciones clínicas que pudieran afectar la interpretación de la imagen. Resultados: Se incluyeron 131 pacientes elegibles (edad media de 43,5 años; 57% hombres) referidos para ULDCT. Dieciocho (13,7%) fueron excluidos. La dosis media de radiación de la ULDCT fue de 0,14 mSv. El intervalo de tiempo entre la solicitud médica y el resultado de la ULDCT fue de 43 minutos. Conclusión: La ULDCT demostró ser viable para pacientes adultos con sospecha de neumonía en un contexto de urgencia. Los informes se disponibilizaron en un intervalo razonable y los resultados negativos se asociaron a una baja tasa de prescripción de antibióticos.

ABSTRACT:
Background: The role of ultra-low-dose chest CT (ULDCT) in the emergency department is unknown. Purpose: This study sought to examine feasibility of ULDCT in adults presenting to the emergency department for whom pneumonia was suspected. Radiation dose and time interval between medical request and ULDCT results were measured, antibiotic prescriptions were correlated. Methods: Between October 2017 and December 2018, we prospectively enrolled consecutive healthy adult patients in a single-center for whom community-acquired pneumonia was suspected and for whom no definitive diagnosis was possible by clinical judgment. Exclusion criteria comprised all chronic conditions that could impact severity and interpretation of image. Results: 131 eligible patients (mean age 43.5 years; 57% men) were enrolled to ULDCT. Eighteen (13.7%) patients were excluded. Average CT radiation dose was 0.14 mSv. Time interval between medical request and ultra-low-dose chest CT result was 43 minutes. Only 15.9% of patients with negative CT received antibiotics. Conclusion: Ultra-low-dose chest CT was feasible for almost all patients in a group of healthy adults presenting to the emergency department with suspected community-acquired pneumonia. Results were made available in a reasonable interval, and negative ones were associated with a low antibiotic prescription rate.

ABSTRACT:
Background: The role of ultra-low-dose chest CT (ULDCT) in the emergency department is unknown. Purpose: This study sought to examine feasibility of ULDCT in adults presenting to the emergency department for whom pneumonia was suspected. Radiation dose and time interval between medical request and ULDCT results were measured, antibiotic prescriptions were correlated. Methods: Between October 2017 and December 2018, we prospectively enrolled consecutive healthy adult patients in a single-center for whom community-acquired pneumonia was suspected and for whom no definitive diagnosis was possible by clinical judgment. Exclusion criteria comprised all chronic conditions that could impact severity and interpretation of image. Results: 131 eligible patients (mean age 43.5 years; 57% men) were enrolled to ULDCT. Eighteen (13.7%) patients were excluded. Average CT radiation dose was 0.14 mSv. Time interval between medical request and ultra-low-dose chest CT result was 43 minutes. Only 15.9% of patients with negative CT received antibiotics. Conclusion: Ultra-low-dose chest CT was feasible for almost all patients in a group of healthy adults presenting to the emergency department with suspected community-acquired pneumonia. Results were made available in a reasonable interval, and negative ones were associated with a low antibiotic prescription rate.