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Significant difference in examination modalities (more patients in the MRI group had an image-based diagnosis explaining their symptomatology than in the CT group), with no effect of gender, age or duration of disease.
Performing an MRI scan as a first-line procedure does not increase average turnaround time or emergency department length of stay.
No significant difference in hospitalization rates or hospital length of stay between the two groups.
Performing an MRI scan as a first-line procedure reduces patient's exposure to ionizing radiation.
Rationale and objectives
Evaluate the implementation of an MRI scanner dedicated to emergencies on the management of patients admitted in the emergency department (ED) for binocular diplopia (BD).
Material and methods
This was a prospective non-interventional single-center study from February 2018 to February 2020. A total of 110 patients were included: 52 patients during the first stage (29 women; 23 men; mean age 65.2 years); 58 during the second stage (29 women; 29 men; mean age 51.4 years). Patients underwent an enhanced-CT examination in the first stage and an MRI examination in the second stage. Criteria used to evaluate the new management of patients were: proportion of patients with an imaging diagnosis explaining BD, turnaround time (TT), ED length of stay (EDLOS), hospital admission rate, hospital length of stay (HLOS), number of MRI examinations requested as a second procedure for the same indication and radiation doses. Descriptive statistics were used to present results with Student's test for quantitative variables and chi-square test for qualitative variables.
Respectively 1 (1.92%) and 17 (29.31%) patients had definitive diagnosis in stages 1 and 2, with a significant difference in examination modalities (p=0.0001). The TT, EDLOS, hospital admission rate, and HLOS were not significantly different between the two stages. Radiation dose was significantly different between the two groups (p<0.05).
Implementation of an MRI scanner dedicated to emergencies can improve the etiological diagnostic performance of binocular diplopia and reduce patient's exposure to ionizing radiation without increasing the average turnaround time or emergency department length of stay.El texto completo de este artículo está disponible en PDF.
Abbreviations : BD, CTA, ED, EDLOS, HLOS, IS, TT
Keywords : Diplopia, Emergency service, Magnetic Resonance Imaging, Length of stay, Radiation dosage