An audit of referrals for acute abdominal CT scans

INTRODUCTION: The number of CTs performed worldwide has increased significantly over the past 20 years, with abdominal CTs being the most common. This trend has raised concerns about patient safety due to lifetime cumulative exposure to cancer-associated ionising radiation. The aim of this study was to evaluate the clinical justification for performing acute abdominal CTs in Danish patients admitted to a surgical department. METHODS: This quality assurance study was conducted as a clinical audit at the North Denmark Regional Hospital. A total of 200 patients who had undergone acute abdominal CTs during a four-year period were randomly selected for review. Two independent audit teams, comprising radiologists and surgeons, assessed clinical justification through a consensus review of medical records. RESULTS: The audit revealed that 36% of the acute abdominal CTs were deemed clinically unjustified. Two-thirds of these CTs were performed for an established or suspected malignancy. CONCLUSIONS: One-third of the acute abdominal CTs were considered unjustified, primarily due to inconsistent or inadequate adherence to regional and national guidelines. Improved physician education and clearer diagnostic imaging guidelines for conditions with diagnostic uncertainty are recommended. FUNDING: None. TRIAL REGISTRATION: Not relevant.