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Chest computed tomography scan utilization and diagnostic outcomes in chronic cough patients with normal chest X-rays: analysis of routinely collected data of a tertiary academic hospital

BACKGROUND: The role of chest computed tomography (CT) scan is controversial in the management of chronic cough patients with normal chest X-rays. We investigated the utilization pattern and diagnostic outcomes of chest CT scans using institutional routinely collected data (RCD) in South Korea. METH...

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Autores principales: An, Jin, Lee, Ji-Hyang, Yoo, Youngsang, Kwon, Hyouk-Soo, Lee, Jae-Seung, Lee, Sei Won, Kim, Tae-Bum, Oh, Yeon-Mok, Cho, You Sook, Lee, Sang-Do, Song, Woo-Jung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10183537/
https://www.ncbi.nlm.nih.gov/pubmed/37197517
http://dx.doi.org/10.21037/jtd-22-1404
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author An, Jin
Lee, Ji-Hyang
Yoo, Youngsang
Kwon, Hyouk-Soo
Lee, Jae-Seung
Lee, Sei Won
Kim, Tae-Bum
Oh, Yeon-Mok
Cho, You Sook
Lee, Sang-Do
Song, Woo-Jung
author_facet An, Jin
Lee, Ji-Hyang
Yoo, Youngsang
Kwon, Hyouk-Soo
Lee, Jae-Seung
Lee, Sei Won
Kim, Tae-Bum
Oh, Yeon-Mok
Cho, You Sook
Lee, Sang-Do
Song, Woo-Jung
author_sort An, Jin
collection PubMed
description BACKGROUND: The role of chest computed tomography (CT) scan is controversial in the management of chronic cough patients with normal chest X-rays. We investigated the utilization pattern and diagnostic outcomes of chest CT scans using institutional routinely collected data (RCD) in South Korea. METHODS: This is a retrospective analysis of adults with chronic cough (>8 weeks in duration) identified from routinely collected electronic health records (EHRs). Structured data were retrieved, including demographics, medical history, symptoms, and diagnostic test results (including chest X-rays and CT scans). Chest CT scan outcomes were classified into major abnormal findings (malignancy, infectious diseases, or other critical conditions that warrant immediate treatment decisions), minor abnormal findings (other abnormal findings), or normal CT. RESULTS: A total of 5,038 chronic cough patients with normal chest X-rays were analyzed. Chest CT scans were performed in 1,006 patients. Prescription of CT scans was significantly associated with older age, male sex, smoking history, and physician-diagnosed history of lung disease. Only 8 of 1,006 (0.8%) patients had major abnormal findings (4 pneumonia, 2 pulmonary tuberculosis, and 2 lung cancer), while 367 (36.5%) had minor findings, and 631 (62.7%) had normal CT scans. However, no baseline parameters were significantly associated with major CT findings. CONCLUSIONS: Chest CT scans were frequently prescribed for chronic cough patients with normal chest X-rays, and abnormal findings were frequently found (37.3%). However, the diagnostic yield for malignancy or infectious disease were low (<1%). Given the potential radiation harm, a routine chest CT scan may not be warranted in chronic cough patients with normal chest X-rays.
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spelling pubmed-101835372023-05-16 Chest computed tomography scan utilization and diagnostic outcomes in chronic cough patients with normal chest X-rays: analysis of routinely collected data of a tertiary academic hospital An, Jin Lee, Ji-Hyang Yoo, Youngsang Kwon, Hyouk-Soo Lee, Jae-Seung Lee, Sei Won Kim, Tae-Bum Oh, Yeon-Mok Cho, You Sook Lee, Sang-Do Song, Woo-Jung J Thorac Dis Original Article on Novel Insights into Chronic Cough BACKGROUND: The role of chest computed tomography (CT) scan is controversial in the management of chronic cough patients with normal chest X-rays. We investigated the utilization pattern and diagnostic outcomes of chest CT scans using institutional routinely collected data (RCD) in South Korea. METHODS: This is a retrospective analysis of adults with chronic cough (>8 weeks in duration) identified from routinely collected electronic health records (EHRs). Structured data were retrieved, including demographics, medical history, symptoms, and diagnostic test results (including chest X-rays and CT scans). Chest CT scan outcomes were classified into major abnormal findings (malignancy, infectious diseases, or other critical conditions that warrant immediate treatment decisions), minor abnormal findings (other abnormal findings), or normal CT. RESULTS: A total of 5,038 chronic cough patients with normal chest X-rays were analyzed. Chest CT scans were performed in 1,006 patients. Prescription of CT scans was significantly associated with older age, male sex, smoking history, and physician-diagnosed history of lung disease. Only 8 of 1,006 (0.8%) patients had major abnormal findings (4 pneumonia, 2 pulmonary tuberculosis, and 2 lung cancer), while 367 (36.5%) had minor findings, and 631 (62.7%) had normal CT scans. However, no baseline parameters were significantly associated with major CT findings. CONCLUSIONS: Chest CT scans were frequently prescribed for chronic cough patients with normal chest X-rays, and abnormal findings were frequently found (37.3%). However, the diagnostic yield for malignancy or infectious disease were low (<1%). Given the potential radiation harm, a routine chest CT scan may not be warranted in chronic cough patients with normal chest X-rays. AME Publishing Company 2023-04-06 2023-04-28 /pmc/articles/PMC10183537/ /pubmed/37197517 http://dx.doi.org/10.21037/jtd-22-1404 Text en 2023 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article on Novel Insights into Chronic Cough
An, Jin
Lee, Ji-Hyang
Yoo, Youngsang
Kwon, Hyouk-Soo
Lee, Jae-Seung
Lee, Sei Won
Kim, Tae-Bum
Oh, Yeon-Mok
Cho, You Sook
Lee, Sang-Do
Song, Woo-Jung
Chest computed tomography scan utilization and diagnostic outcomes in chronic cough patients with normal chest X-rays: analysis of routinely collected data of a tertiary academic hospital
title Chest computed tomography scan utilization and diagnostic outcomes in chronic cough patients with normal chest X-rays: analysis of routinely collected data of a tertiary academic hospital
title_full Chest computed tomography scan utilization and diagnostic outcomes in chronic cough patients with normal chest X-rays: analysis of routinely collected data of a tertiary academic hospital
title_fullStr Chest computed tomography scan utilization and diagnostic outcomes in chronic cough patients with normal chest X-rays: analysis of routinely collected data of a tertiary academic hospital
title_full_unstemmed Chest computed tomography scan utilization and diagnostic outcomes in chronic cough patients with normal chest X-rays: analysis of routinely collected data of a tertiary academic hospital
title_short Chest computed tomography scan utilization and diagnostic outcomes in chronic cough patients with normal chest X-rays: analysis of routinely collected data of a tertiary academic hospital
title_sort chest computed tomography scan utilization and diagnostic outcomes in chronic cough patients with normal chest x-rays: analysis of routinely collected data of a tertiary academic hospital
topic Original Article on Novel Insights into Chronic Cough
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10183537/
https://www.ncbi.nlm.nih.gov/pubmed/37197517
http://dx.doi.org/10.21037/jtd-22-1404
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