Does Limiting Oral Contrast Decrease Emergency Department Length of Stay?

Abstract

Introduction: The purpose of this study was to examine the impact on emergency department (ED)length of stay (LOS) of a new protocol for intravenous (IV)-contrast only abdominal/pelvic computedtomography (ABCT) compared to historical controls.Methods: This was a retrospective case-controlled study performed at a single academic medicalcenter. Patients ≥ 18 undergoing ABCT imaging for non-traumatic abdominal pain were included inthe study. We compared ED LOS between historical controls undergoing ABCT imaging with PO/IVcontrast and study patients undergoing an IV-contrast-only protocol. Imaging indications were thesame for both groups and included patients with clinical suspicion for appendicitis, diverticulitis, smallbowel obstruction, or perforation. We identified all patients from the hospital’s electronic storehouse(imaging code, ordering department, imaging times), and we abstracted ED LOS and dispositionfrom electronic medical records.Results: Two hundred and eleven patients who underwent PO/IV ABCT prep were compared to 184patients undergoing IV-contrast only ABCT prep. ED LOS was shorter for patients imaged with theIV-contrast only protocol (4:35 hrs vs. 6:39 hrs, p < 0.0001).Conclusion: Implementation of an IV-contrast only ABCT prep for select ED patients presentingfor evaluation of acute abdominal pain significantly decreased ED LOS.

Keywords

• emergency department
• oral contrast
• length of stay