A high-tech CT scan may not be needed if you have an efficient physician, whose bedside exam can often be more effective, a new study claims.
A Loyola University Health System study has found physicians' bedside exams did a better job than CT scans in predicting which patients would have to be operated.
AdvertisementResearchers noted the records of 251 patients who received CT scans within 24 hours of surgery at Loyola.
They included 133 patients who received routine scans within seven hours of surgery and 108 patients who received routine scans between 8 hours and 24 hours after surgery.
However, none of the routine scans predicted which patients would need to return to the operating room.
Patients had also received bedside neurological exams by physicians. In 10 cases, physicians detected serious problems, such as being slow to wake up, that warranted an urgent CT scan.
Three of these urgent scans (30 percent) confirmed the patients' problems were serious enough to require a return to the operating room.
By comparison, 0 percent of the 241 routine CT scans predicted whether patients would have to return to the emergency room.
A normal CT scan given right after surgery might give a doctor a false sense of security, which could lead to less frequent monitoring and neurological exams.
Of the 14 patients in the study who took a serious turn for the worse, 13 had had CT scans within four hours of surgery that were normal or showed only minor problems.
The researcher pointed out that transporting patients to scanning machines "involves multiple personnel of varying skills and nursing staff who are taken away from their other unit responsibilities. These scans also often interfere with work flow efficiencies of the radiology department."
They added: "The low cost, simple, but elegant neurological exam appears to be superior to a routine CT scan in determining return to the operating room,"Dr. Thomas Origitano, senior author and chairman of the Department of Neurological Surgery, concluded: "Scanning technology is really good. But applying it without a physician's input is not necessarily helpful."
The study appears in the Journal of Neurosurgery.