CT not cost-effective to investigate dizziness

Performing head CT scans in the emergency room isn't cost-effective for patients complaining of dizziness, according to a study presented on January 26 at the Triological Society's Combined Sections Meeting in Miami Beach, FL.

The retrospective review of 1,681 patients presenting to the emergency department with dizziness and vertigo led to intervention for intracranial hemorrhage or stroke in fewer than 1% of patients, according to researchers from Henry Ford Hospital.

Many physicians use imaging as a first-line modality to quickly rule out more serious causes, Dr. Syed Ahsan and colleagues reported. However, a look at CT scans ordered on patients with dizziness and vertigo in the emergency room yields a low predictive value for significant pathology.

Nearly half of the patients presenting between January 2008 and January 2011 (n = 810) received a CT scan of the brain and head, but only 0.74% had clinically significant results that required intervention. And the cost of those scans was $988,200.

The results highlight a great potential for cost savings by implementing stricter guidelines for ordering emergency department CT scans for these patients, the group wrote in an accompanying abstract. They hope the results will shed light on effective ways to cut unnecessary expenditures and serve as a model for other healthcare systems, they concluded.