Impact of the COVID-19 pandemic on emergency department CT for suspected diverticulitis
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ORIGINAL ARTICLE
Impact of the COVID-19 pandemic on emergency department CT for suspected diverticulitis Averi L. Gibson 1
&
Byron Y. Chen 1 & Max P. Rosen 1 & S. Nicolas Paez 1 & Hao S. Lo 1
Received: 26 August 2020 / Accepted: 18 October 2020 # American Society of Emergency Radiology 2020
Abstract Purpose This study examined the impact of the COVID-19 pandemic on emergency department CT use for acute nontraumatic abdominal pain, to better understand why imaging volume so drastically decreased during the COVID-19 pandemic. Methods This was a retrospective review of emergency imaging volumes from January 5 to May 30, 2020. Weekly volume data were collected for total imaging studies, abdominopelvic CT, and abdominopelvic CTs positive for common causes of acute nontraumatic abdominal pain. Two emergency radiology attendings scored all diverticulitis cases independently, and weekly volume data for uncomplicated and complicated diverticulitis cases was also collected. Volume data prior to and during the COVID-19 pandemic was compared, using 2019 volumes as a control. Results During the COVID-19 pandemic, overall emergency imaging volume decreased 30% compared to 2019 (p = 0.002). While the number of emergency abdominopelvic CTs positive for appendicitis and small bowel obstruction did not significantly change during the COVID-19 pandemic, the number of cases of diverticulitis decreased significantly compared to 2019 (p = 0.001). This reduction can be specifically attributed to decreased uncomplicated diverticulitis cases, as the number of uncomplicated diverticulitis cases dropped significantly (p = 0.002) while there was no significant difference in the number of complicated diverticulitis cases (p = 0.09). Conclusions Reduced emergency abdominopelvic CT volume during the COVID-19 pandemic can partially be explained by decreased imaging of lower acuity patients. This data may help formulate future strategies for imaging resource utilization with an improved understanding of the relationship between perceived imaging risk and symptom acuity. Keywords COVID-19 . CT utilization . Abdominopelvic CT . Diverticulitis
Introduction Since the first reported case from Wuhan, China, in December 2019, coronavirus disease 2019 (COVID-19) has spread quickly across the world. To date, there have been over 23,000,000 cases and over 810,000 deaths reported to the World Health Organization [1]. As of late August, the USA has been particularly affected, accounting for over 5,600,000 infections and 175,00 deaths [2]. Within this short time frame, the COVID-19 pandemic has dramatically impacted most
* Averi L. Gibson [email protected] 1
Department of Radiology, University of Massachusetts Medical School, 55 North Lake Avenue, Worcester, MA 01655, USA
aspects of the US healthcare system. Within radiology, most nonurgent outpatient imaging was postponed. Imaging volumes during the initial stages of the COVID-19 pandemic decreased across all patient care settings: inpatient, outpatient, and emergency [3–6]. Studies have
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