NON-TRAUMATIC NON-COVID-19 RELATED FINDINGS IN EMERGENCY CHEST MULTIDETECTOR COMPUTED TOMOGRAPHY. A RETROSPECTIVE STUDY
DOI:
https://doi.org/10.22551/3m33gf82Abstract
This study aims to analyze the non-traumatic and non-COVID-19-related findings detected in patients presenting to the emergency department with acute chest pain who underwent chest multidetector computed tomography (MDCT) and the relationship with patient gender and treatment solutions. Materials and methods: We retrospectively selected and reviewed the radiological reports of a cohort of 378 patients who underwent chest MDCT in emergency at “Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania, between January 1, 2021, and July 1, 2024. Exclusion criteria were recent trauma history, a positive PCR test for COVID-19, and acute myocardial infarction. MDCT examinations were performed using a 16-slice Siemens Somatom Emotion CT scanner and a 64-slice Philips Incisive CT scanner. Results: Among the 378 patients, 222 were males (58.7%) and 156 were females (41.3%), with a mean age of 73.8 years (SD 10.767; CI 72.55-75.06; range 35-94 years). We classified the lesions into four categories: pleuro-pulmonary (51.58%), cardiac (24.9%), vascular (16.55%), malignant (6.97%). Life-threatening findings were present in only 21.42% of cases, including pulmonary embolism (14.8%), acute pulmonary edema (2.3%), descending aorta dissection (0.7%), and massive pleural effusion (0.7%). The most common primary malignancy was lung cancer. Conclusions: This study underlines the importance of correctly identifying and managing the chest CT findings in the case of patients examined in emergencies.
References
1. Bicci E, Grazzini G, Cozzi D, D et al. Non-traumatic non-cardiovascular thoracic emergencies: role of imaging. Eur Rev Med Pharmacol Sci 2022; 26: 3249-3260.
2. Pescatori LC, Brambati M, Messina C, et al. Clinical impact of computed tomography in the emergency department in nontraumatic chest and abdominal conditions. Emerg Radiol 2018; 25: 393-398.
3. Palumbo P, Cannizzaro E, Bracci A, et al. Thoracic non-traumatic cardiovascular diseases: current perspective and multi-detectors Computed Tomography protocols optimization in the emergency setting Eur Rev Med Pharmacol Sci 2022; 26: 3621-3641.
4. Cairns C, Kang K. National Hospital Ambulatory Medical Care Survey: 2019 Emergency Department Summary Tables, 2022.
5. Seidel J, Bissell MB, Vatturi S, Hartery A. Retrospective Analysis of Emergency Computed Tomog-raphy Imaging Utilization at an Academic Centre: An Analysis of Clinical Indications and Outcomes. Canad Assoc Radiol J 2019; 70(1): 13-22.
6. Kocher KE, Meurer WJ, Fazel R, Scott PA, Krumholz HM, Nallamothu BK. National trends in use of computed tomography in the emergency department. Ann Emerg Med 2011; 58(5): 452-462.
7. Morsbach F, Hinzpeter R, Higashigaito K, et al. Chest pain CT in the Emergency Department: evalu-ating the coronary arteries even when not specifically asked for? Acta Radiol 2018; 59(11): 1309-1315.
8. Fruergaard P, Launbjerg J, Hesse B, et al. The diagnoses of patients admitted with acute chest pain but without myocardial infarction. Eur Heart J 1996; 17(7): 1028-1034.
9. Magadan GJ, Hickham DH. Noncardiac causes of angina- like chest pain. Progr Cardiovasc Dis 1986; 29: 65-80.
10. Dandan OA, Hassan A, AbuAlola H, et al. Clinical and imaging profiles of pulmonary embolism: A single-institution experience. Int J Emerg Med 2020; 13: 47.
11. Henzler T, Barraza JM Jr., Nance JW Jr, et al. CT imaging of acute pulmonary embolism. J Cardiovasc Comput Tomogr 2011; 5: 3-11.
12. Wazzan MA, Abduljabbar A, et al. Trends in the utilization of computed tomography chest for acute pulmonary embolism in the emergency department and the yield in treatment. Saudi J Health Sci 2014; 13(1): 21-27.
13. Whiting P, Singatullina N, Rosser JH Computed tomography of the chest: I. Basic principles. BJA Education 2015; 15(6): 299-304.
14. Valente T, Rossi G, Lassandro F, et al. MDCT evaluation of acute aortic syndrome (AAS). Br J Radiol 2016; 89: 1061.
15. de Jong CMM, Kroft LJM, van Mens TE, Huisman MV, Stöger JL, Klok FA. Modern imaging of acute pulmonary embolism. Throm Research 2024; 238: 105-116.
16. Huisman M.V, Klok FA Diagnostic management of acute deep vein thrombosis and pulmonary em-bolism. J Thromb Haemost 2013; 11(3): 412-422.
17. Hesse B, Jørgensen F, Petri A, Eiken P, Aggestrup S, Elsborg L, Mellemgaard K. The diagnoses of patients admitted with acute chest pain but without myocardial infarction. Eur Heart J 1996; 7(7): 1028-1034.
18. Timpau AS, Miftode RS, Costache II, et al. An Overview of the Impact of Bacterial Infections and the Mortality Predictors in Patients with COVID-19 Admitted to a tertiary Center from Eastern Europe Antibiot Chemother 2023; 12 (1): 144.
19. Galesanu C, Buzduga C, Florescu A, Moisii L, Ciubotaru V. Diabetes mellitus, chronic complication in patients with acromegaly: case report and review of the literature. Med Surg J-Rev Med Chir Soc Med Nat Iasi 2015; 119(1): 92-96.
20. Ursaru M, Jari I, Gheorghe, Naum AG, Scripcariu V, Negru D. Bilateral breast cancer: diagnosis and prognosis. Med Surg J-Rev Med Chir Soc Med Nat Iasi 2016; 120(2): 316-320.
21. Manafu EG, Filimon RM, Jari I, et al. Clinical epidemiological study on the incidence of Escherichia coli infections in the cancer patients admitted to Surgery Department II of the Iasi Regional Oncology Institute. Med Surg J-Rev Med Chir Soc Med Nat Iasi 2018; 118(3): 796-800.
22. Jari I, Naum AG, Moisii LG, et al. Comparative Study by Analytical Multidisciplinary Methods and Oxidative Stress in Breast Cancer Diagnosis. Rev Chim 2018; 69(8): 2254-2259.
23. Gheorghe L, Jari I, Naum AG. Neuroendocrine tumors: Choosing the appropriate imaging methods. Med Surg J-Rev Med Chir Soc Med Nat Iasi 2018; 122(1): 16-22.
24. Jari I, Ursaru M, Naum AG, Gheorghe L, Moisii P, Negru D. Pancreatic cancer CT imaging: compar-ison with surgery Med Surg J-Rev Med Chir Soc Med Nat Iasi 2016; 120(2): 371-375.
25. Savin ML, Mihai F, Gheorghe L, et al. Proposal of a Preoperative CT-Based Score to Predict the Risk of Clinically Relevant Pancreatic Fistula after Cephalic Pancreatoduodenectomy. Medicina Lithuania 2021; 57(7): 650.
26. Volovat SR, Ursulescu-Lupascu CV, Gheorghe ML, et al. The landscape of nanovectors for modula-tion in cancer immunotherapy. Pharmaceutics 2022; 14(2): 397.
27. Moisii P, Jari I, Ursu AM, et al. The Relationship between Job Strain and Ischemic Heart Disease Mediated by Endothelial Dysfunction Markers and Imaging. Medicina Lithuania 2024; 60(7): 1048.
Additional Files
Published
Issue
Section
License
Copyright (c) 2025 The Medical-Surgical Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
COPYRIGHT
Once an article is accepted for publication, MSJ requests a transfer of copyrights for published articles.
COPYRIGHT TRANSFER FORM FOR
REVISTA MEDICO-CHIRURGICALĂ A SOCIETĂȚII DE MEDICI ȘI NATURALIȘTI DIN IAȘI /
THE MEDICAL-SURGICAL JOURNAL OF THE SOCIETY OF PHYSICIANS AND NATURALISTS FROM IASI
We, the undersigned authors of the manuscript entitled
_____________________________________________________________________________________
_____________________________________________________________________________________
warrant that this manuscript, which is submitted for publication in the REVISTA MEDICO-CHIRURGICALĂ, has not been published and it is not under consideration for publication in another journal.
- we give the consent for publication in the REVISTA MEDICO-CHIRURGICALĂ, in printed and electronic format and we transfer unconditioned and complete the copyright of this manuscript to the REVISTA MEDICO-CHIRURGICALĂ, in the event of its acceptance.
- the manuscript does not break the intellectual property rights of any other person.
- we have read the submitted version of the manuscript and we are fully responsible for the content.
Names and signatures of authors / copyright owners (the following sequence is the authorship of the article):
- ______________________________/_________________________
- ______________________________/_________________________
- ______________________________/_________________________
N.B. All the authors must sign this form
