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| 1 | Computed tomography scan imaging in diagnosing acute uncomplicated pancreatitis: Usefulness vs cost显示文摘BACKGROUND Literature has suggested that imaging is over-utilized in the diagnosis of pancreatitis. If the diagnosis of acute pancreatitis(AP) is established with abdominal pain and increased serum amylase or lipase activity without systemic signs of severe disease, computed tomography(CT) imaging may not be necessary. We hypothesize that among patients with uncomplicated acute pancreatitis(AUP), there is a significant number of unwarranted CT imaging studies. This imposes increased expenditure and cost in our healthcare system and does not improve hospital stay or management of AUP.AIM To assess the overutilization and associated cost of CT imaging among patients meeting diagnostic criteria for AUP.METHODS In this Institutional Review Board-approved retrospective, single-center study,we identified all adult patients admitted with AP from January 1, 2012 through October 1, 2017. Patients were identified via International Classification of Diseases(ICD-9) code for AP(577.0) and ICD-10 codes for different etiological AP(K85.9 unspecified, K85.0 idiopathic, K85.1 biliary, K85.2 alcohol-induced, K85.3 drug-induced, and K85.8 other). Diagnosis was confirmed by chart review using established non-imaging diagnostic criteria(presence of typical abdominal pain and elevated lipase or amylase greater than 3 times upper limit of normal).Ranson criteria and BISAP scores on presentation were calculated and patients that met scores less than or equal to 2 for both were included to suggest AUP.The utilization and cost of imaging in these patients were recorded.RESULTS Between January 2012 and October 2017, 1305 patients presented to the emergency department with AP, and 405 patients(31%) met our inclusion criteria for AUP(201 males, 204 females; mean age 49 years, range 18-98). Of those, 210 patients(51.85%) underwent CT imaging. One patient(0.47%) had evidence of pancreatic necrosis, one patient had cyst formation(0.47%), and the remaining208 patients(99.05%) had either normal CT scan imaging or findings consistent with mild AP without necrosis. The average cost of CT scan imaging was $4510 with a total cost of $947056. Median length of hospitalization stay was 3 d among both groups. Combining Ranson's Criteria and BISAP score identified AUP in our patient population with an accuracy of 99.5%.CONCLUSION CT imaging is unnecessary when AUP is diagnosed clinically and biochemically.Reducing overuse of diagnostic CT scans will decrease healthcare expenditure and radiation exposure to patients. | Shana Kothari Michael Kalinowski Matthew Kobeszko Tarek Almouradi | 2019 | World Journal of Gastroenterology2019，25，9： | 5 |
| 2 | Presidential leadership and charisma: The effects of metaphor显示文摘 | Jeffery Scott Mio Ronald E. Riggio Shana Levin Renford Reese | 2005 | The Leadership Quarterly2005，，2： | 2 |
| 3 | Putting renewables and energy efficiency to work: How many jobs can the clean energy industry generate in the US?显示文摘 | Max Wei Shana Patadia Daniel M. Kammen | 2009 | Energy Policy2009，，2： | 2 |
| 4 | Surface flattening based on energy model 显示文摘 | Charlie CL Wang Shana SF Smith Matthew MF Yuen | 2002 | Computer-Aided Design2002，，11： | 2 |
| 5 | How does male-male competition generate negative frequency-dependent selection and disruptive selection during speciation?显示文摘 | Peter D. DIJKSTRA Shana E. BORDER | 2018 | Current Zoology2018，64，1： | 2 |
| 6 | Sometimes I’ll start a sentence in Spanish Y TERMINO EN ESPA?OL: toward a typology of code-switching<sup>1</sup>显示文摘 | SHANA POPLACK | 2009 | Linguistics (-)2009，，7： | 2 |
| 7 | Remote Ischemic Conditioning Reduces Myocardial Infarct Size and Edema in Patients With ST-Segment Elevation Myocardial Infarction显示文摘 | Steven K. White Georg M. Frohlich Daniel M. Sado Viviana Maestrini Marianna Fontana Thomas A. Treibel Shana Tehrani Andrew S. Flett Pascal Meier Cono Ariti John R. Davies James C. Moon Derek M. Yellon Derek J. Hausenloy | 2014 | JACC: Cardiovascular Interventions2014，，： | 1 |
| 8 | Reactions of formaldehyde plus acetaldehyde with deoxyguanosine and DNA: Formation of cyclic deoxyguanosine adducts and formaldehyde cross-links显示文摘 | Guang Cheng Yongli Shi Shana J Sturla | 2003 | Chem Res Toxicol2003，16，： | 1 |
| 9 | The relationships between automobile head-up display presentation images and driver' kansei 显示文摘 | Shana Smith Shih-Hang Fu | 2011 | Displays2011，，32： | 1 |
| 10 | The effect of university roommate contact on ethnic attitudes and behavior显示文摘 | Colette Van Laar Shana Levin Stacey Sinclair Jim Sidanius | 2004 | Journal of Experimental Social Psychology2004，，4： | 1 |
| 11 | The sociology of aging and the aged显示文摘 | Shanas E | 1971 | The Sociological Quarterly1971，12，： | 1 |
| 12 | The social correlates and linguistic processes of lexical borrowing and assimilation显示文摘 | SHANA POPLACK DAVID SANKOFF CHRISTOPHER MILLER | 2009 | Linguistics2009，，1： | 1 |
| 13 | Orienting DNA helices on gold using applied electric fields显示文摘 | Shana O K Jacqueline K B | 1998 | Langmuir1998，14，24： | 1 |
| 14 | Angioplasty of acquired pulmonary vein stenosis using covered stent显示文摘 | Shana Tehrani David Lipkin | 2013 | Cathet Cardiovasc Intervent2013，，4： | 1 |
| 15 | Miniemulsion polymerization of aerylated methyl oleate for pressure sensitive adhesives显示文摘 | SHANA BUNKER CHRISTELIE STALLER | 2003 | International Journal of Adhesion&Adhesive2003，23，： | 1 |
| 16 | Frequency-scalSuable SiGe bipolar RF front-end design 显示文摘 | Osama Shana ' a Ivan Linscott Len Tyler | 2001 | IEEE J Solid-State Circuits2001，36，6： | 1 |
| 17 | Miniemulsion polymerization of acrylated methyl oleate for pressure sensitive adhesives 显示文摘 | Shana Bunker Christelle Staller Norbert Willenbacher | 2003 | International Journal of Adhesion and Adhesives2003，23，1： | 1 |
| 18 | International journal of adhesion adsheives,miniemulsion polymerization of acrylated methyl oleate for pressure sensitive adhesives显示文摘 | Christelle Staller | 2003 | Norbert Willenbacher and Richard Wool2003，23，1： | 1 |
| 19 | Synthesis of colloidal CuGaSe2, CuInSe2, and Cu(InGa)Se2 nanoparti- cles 显示文摘 | Tang Jiang Sean Hinds Shana O Kelley | 2008 | Chem Mater2008，20，22： | 1 |
| 20 | Stabiliza- tion of collagen by cross-linking with oxazolidine E-resorcinol 显示文摘 | Chen Hui Shana Zhi Hua | 2010 | Bi- ological Macromolecules2010，46，5： | 1 |
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