Comparison of tomographic reports by radiologists and non-radiologists in trauma and interferences in management in a trauma reference center

• Published in: Revista do Colégio Brasileiro de Cirurgiões 2023, Vol.50
• Main Authors: NOGUEIRA, GABRIEL MONDIN, RAFAEL, LEONARDO KRIEGER, REICHARDT, GABRIEL SEBBEN, DALL’AGNOL, MATEUS, PIMENTEL, SILVANIA KLUG
• Format: Article
• Language: English
• Subjects: Diagnostic Errors; Medical Errors; Mental Fatigue; Multiple Trauma; Original; Tomography, X-Ray Computed
• ISSN: 0100-6991; 1809-4546
• DOI: 10.1590/0100-6991e-20233530-en

ABSTRACT Objective: diagnostic errors during the interpretation of an imaging test by the physician can lead to increased mortality and length of hospital stay for patients. The rate of divergence in the report given by a radiologist and an Emergency Physicians (EP) can reach over 20%. The objective of this study was to compare the unofficial tomographic reports issued by EP with the official reports issued by radiologists. Methods: a cross-sectional study, in which interpretations of the exams (documented in the medical records by the EP) of all patients undergoing computed tomography (CT) of the chest, abdomen or pelvis performed in the emergency room, at an interval of 8 months, were evaluated. These data were compared with the official reports of the radiologist (gold standard). Results: 508 patients were included. The divergence between EP and the radiologist occurred in 27% of the cases. The most common type of divergence was the one not described by the EP, but described by the radiologist. The chance of having divergence in a case of multiple trauma is 4.93 times greater in relation to the case of only blunt trauma in one segment. A statistically relevant difference was also found in the length of stay of patients who had different interpretations of the CT scans. Conclusion: the study found a relatively high divergence rate between the EP report and the official radiologist report. However, less than 4% of these were considered to be clinically relevant, indicating the ability of the EP to interpret it satisfactorily. RESUMO Objetivo: os erros diagnósticos durante a interpretação de um exame de imagem pelo médico podem acarretar aumento da mortalidade e do tempo de internação dos pacientes. A taxa de divergência entre o laudo dado por um médico radiologista e a avaliação preliminar de um Médico Emergencista (ME) pode chegar a mais de 20%. O objetivo deste trabalho foi comparar as avaliações dos exames de imagem realizadas pelo ME com os laudos oficiais emitidos pelos radiologistas. Métodos: estudo seccional e transversal, no qual foram avaliadas interpretações dos exames (documentadas no prontuário pelos ME) de todos os pacientes submetidos à tomografia computadorizada (TC) de tórax, abdome ou pelve realizada na emergência, em um intervalo de 8 meses. Esses dados foram comparados com os laudos oficiais do médico radiologista (padrão ouro). Resultados: foram incluídos 508 pacientes no estudo. A divergência entre ME e radiologista ocorreu em 27% dos