Incidental Findings on CT Scans in the Emergency Department

Objectives . Incidental findings on computed tomography (CT) scans are common. We sought to examine rates of findings and disclosure among discharged patients who received a CT scan in the ED. Methods . Retrospective chart review (Aug-Oct 2009) of 600 patients age 18 and older discharged home from an urban Level 1 trauma center. CT reports were used to identify incidental findings and discharge paperwork was used to determine whether the patient was informed of these findings. Results . There were 682 CT scans among 600 patients: 199 Abdomen & Pelvis, 405 Head, and 78 Thorax. A total of 348 incidental findings were documented in 228/682 (33.4%) of the scans, of which 34 (9.8%) were reported to patients in discharge paperwork. Patients with 1 incidental finding were less likely to receive disclosure than patients with 2 or more ( P = .010). Patients age <60 were less likely to have incidental findings ( P < .001). There was no significant disclosure or incidental finding difference by gender. Conclusions . While previous research suggests that CT incidental findings are often benign, reporting to patients is recommended but this is rarely happening.