Posted on November 16, 2009
Radiation exposure high in patients presenting to the ED with acute MI
American
Heart Association Scientific Sessions 2009
Patients admitted to the hospital with an acute MI are
on average exposed to 17 mSv per visit— the equivalent of 850 chest
radiographs, according to data presented today.
“Thus far, procedures involving ionizing radiation
have only been considered in isolation and we believe a more appropriate way of
thinking about this is to consider the accumulative effective radiation dose
for a given diagnosis — this may effect change,” Prashant Kaul,
MD, fellow in cardiovascular medicine at Duke University Medical Center in
North Carolina, said during a presentation.
Kaul and colleagues assessed the total number of chest
radiograph, CT chest, CT body, CT head, nuclear rest/stress perfusion, nuclear
MUGA, nuclear ventilation/perfusion scan and cardiac catheterization procedures
in 21,705 men and 14,002 women admitted for an acute MI at one of 55 hospitals
participating in the University Health System Consortium.
Overall 248,822 ionizing radiation procedures were
performed on the study cohort; an average of seven procedures per patient. The
average cumulative effective dose was 17.13 mSv per patient, per hospital
visit.
Eighty-six percent of patients had a chest X-ray, 50%
had catheter procedures, 26% underwent CT scans and 21% had a head CT
performed.
The researchers reported several limitations to the
study. The reported cumulative radiation dose per patient is an estimate and
not an actual measurement. In addition, tests assessed were those only used to
assess MIs, yet physicians may utilize other types of tests.
“Further research is needed to understand the
indications of a noninvasive test involving ionized radiation during acute MI
care. Further efforts should be directed towards reducing total exposure dose
by the admitting diagnosis and also towards methods potentially trying to
assess real time radiation exposure during clinical care,” Kaul concluded.
– by Jennifer Southall
For more information:
- Kaul P. #998. Presented at: the American Heart Association 2009
Scientific Sessions; Nov. 14-18; Orlando, Fla.
