The following is a summary of “Utility of the abdominal series in the emergency setting: a retrospective review,” published in the January 2024 issue of Emergency Medicine by Hogan et al.

Despite growing doubts about its effectiveness, the abdominal X-ray (AXR) remains a standard examination in emergency departments (ED). 

Researchers conducted a retrospective ED study to quantify AXR order frequency, subsequent imaging reliance, and associated time costs, aiming to validate their hypothesis of low clinical utility and extended ED stays.

They reviewed AXRs conducted in the ED carried out for the period from January to December 2019. Data variables were gathered using the local picture archiving and communication system (PACS) and electronic medical records.

The result showed that in 701 AXRs, 438 (62.4%) yielded normal results, while 263 (37.6%) were abnormal. A Chi-Squared test indicated a significant association between abdominal series results and completion of follow-up imaging where P<0.001, albeit with a small effect size (Nagelkerke R square = 0.022). Patients spent an average of 7.27 hours in the emergency department, and the average time from AXR order to interpretation was 1.31 hours.

Investigators concluded that the predominance of normal AXR results revealed a statistically significant but clinically low predictive capacity for subsequent imaging, affirming the hypothesis of limited clinical utility; addressing AXR overuse could potentially reduce ED patient duration.

Source: intjem.biomedcentral.com/articles/10.1186/s12245-023-00580-3