Purpose: To investigate whether CT examinations done in non-trauma patients after regular working hours made an impact in patient care.

Method and Materials: A review of medical records was done for a two-month period on patients who presented with non-trauma emergencies. In these patients, the post-imaging diagnosis was compared to the pre-imaging referral diagnosis and physical findings. The impact of imaging on further patient management was determined after retrospectively reviewing the discharge summaries from the hospital record.

Results: Among the 274 patients undergoing after-hours Emergency CT scans for non-trauma related conditions, 130 (47%) were neuro-related and 141 (51%) were body CT scans. Thirty-nine (30%) neuro scans were requested for specific reasons and 91 (70%) were requested for generic reasons such as nonspecific mental status changes. Among the neuro scans requested for specific reasons based on the clinical findings, 43% had a significant finding like intracranial hemorrhage, ischemic change, or space occupying lesion. Only 11% of the scans requested for non-localizing subjective reasons had a significant finding. Of the body examinations, 58 (41%) were requested based on subjective symptoms such as RLQ pain/nausea/abdominal pain and 83 (59%) were requested for specific indications such as “rule out appendicitis/PE/diverticulitis/SBO.” Out of the 83 examinations performed with a specific diagnostic question, 57% had a significant finding. Of the examinations performed for symptomatic indication, 43% showed significant findings. Overall, imaging influenced patient care in 118 (43%) of patients, resulting in their admission or discharge.

Conclusions: From our study, it was concluded that imaging plays a pivotal role with respect to patient admission and discharge in the acute setting. For neuroradiologic studies, the yield of positive findings is greater when a specific diagnosis is sought. However, the findings of studies performed for generic indications played an important role in patient care. For body imaging, there is no significant difference in the results of the scans whether they were performed for symptomatic or specific indications.

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