E0614 - Utilization of CT Scan in Premenopausal Women Presenting With Non-Traumatic Abdominal Pain

Sean-Patrick Prince, MD, MPH¹, Qitan Huang, DO², Denisse Camille Dayto, MD², Andrew Sephien, MD², Trupti Shinde, MD^2
1University of Miami/Holy Cross Health, Inverness, FL; ²HCA Florida Citrus Hospital, Inverness, FL

Introduction: Abdominal and pelvic computed tomography (CTAP) has long been considered the test of choice for abdominal pain. We hypothesize that because women are more likely to present with acute abdominal pain and they would be subject to increased imaging studies and radiation exposure. The purpose of this study was to assess the difference in the utilization of CTAP among young men and women who present with non-traumatic abdominal pain.

Methods: This retrospective cohort was conducted between 01/2017 - 12/2019. Those who presented to the emergency department with acute abdominal pain were included. Those who presented with acute abdominal pain due to traumatic injury or with a previous history of abdominal pathology were excluded. Patient demographics, and medical comorbidities were collected. Logistic regression analysis was performed to determine the effect of gender on the likelihood of CTAP imaging and reported as odds ratios (OR) with 95% confidence intervals (CI). Significance was set at 5%.

Results: A total of 3,328 patients who presented to the emergency department were identified. The mean reported age was 33.5 years with a maximum of 45 years. The majority of patients were (65.5%). The racial demographics showed that 75.7% were white, 12.3% were black, 1% were Asian and 11% identified as other/unknown. Only 17.4% of patients identified as hispanic with most patients specifying they were non-hispanic (82%) and only 0.6% choosing to not specify. A total of 2,345 patients were insured and 71.9% of patients received a CT scan.

Adjusted analysis revealed that women were significantly less likely than men to recieve CTAP (OR 0.79, 95% CI (0.67, 0.94), p = 0.01). Uninsured patients were significantly more likely than insured patients to recieve CTAP (OR 1.27, 95% CI (0.1.07, 0.52), p = 0.01) ad 27% higher odds of receiving a CT scan versus insured patients (p = 0.01, 95% CI, OR [1.07, 1.52]). In regards to age, for every 1-year increase in patient age, there was a corresponding 3% increase in the patient’s odds of receiving a CT scan (p< 0.001, 95% CI, OR [1.02, 1.04]).

Discussion: Despite the majority of patients being females; females were less likely to undergo CTAP when presenting with acute abdominal pain compared to men. Although our hypothesis was that female patients were more likely to undergo CTAP, these results could represent an under-utilization of CTAP imaging in younger women. Additional studies are needed to elicit the impact of this underutilization and patient outcomes.


Disclosures:


Sean-Patrick Prince, MD, MPH¹, Qitan Huang, DO², Denisse Camille Dayto, MD², Andrew Sephien, MD², Trupti Shinde, MD². E0614 - Utilization of CT Scan in Premenopausal Women Presenting With Non-Traumatic Abdominal Pain, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.