Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsis
Abstract Objectives To survey physicians’ views on the risks and benefits of computed tomography (CT) in the management of septic patients and indications for and contraindications to contrast media use in searching for septic foci. Methods A web-based questionnaire was administered to physicians at...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s13244-024-01894-3 |
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| author | Maria Isabel Opper Hernando Denis Witham Ann-Christine Stahl Peter Richard Steinhagen Stefan Angermair Wolfgang Bauer Friederike Compton Andreas Edel Jan Matthias Kruse York Kühnle Gunnar Lachmann Susanne Marz Holger Müller-Redetzky Jens Nee Oliver Paul Damaris Praeger Carsten Skurk Miriam Stegemann Alexander Uhrig Stefan Wolf Myrto Bolanaki Kerstin Rubarth Joachim Seybold Elke Zimmermann Marc Dewey Julian Pohlan |
| author_facet | Maria Isabel Opper Hernando Denis Witham Ann-Christine Stahl Peter Richard Steinhagen Stefan Angermair Wolfgang Bauer Friederike Compton Andreas Edel Jan Matthias Kruse York Kühnle Gunnar Lachmann Susanne Marz Holger Müller-Redetzky Jens Nee Oliver Paul Damaris Praeger Carsten Skurk Miriam Stegemann Alexander Uhrig Stefan Wolf Myrto Bolanaki Kerstin Rubarth Joachim Seybold Elke Zimmermann Marc Dewey Julian Pohlan |
| author_sort | Maria Isabel Opper Hernando |
| collection | DOAJ |
| description | Abstract Objectives To survey physicians’ views on the risks and benefits of computed tomography (CT) in the management of septic patients and indications for and contraindications to contrast media use in searching for septic foci. Methods A web-based questionnaire was administered to physicians at a large European university medical center in January 2022. A total of 371 questionnaires met the inclusion criteria and were analyzed with physicians’ work experience, workplace, and medical specialty as independent variables. Chi-square tests were used for exploratory analysis. Results While physicians with all levels of work experience were included, the largest group (35.0%, n = 130/371) had 3–7 years of experience. Most physicians agreed that the benefits of CT outweigh its potential adverse effects in septic patients (90.5%, n = 336/371). Responders saw the strongest indication for contrast media administration in septic patients for (1) CT examinations of the abdomen (92.7%, n = 333/359) and (2) combined CT examinations of the chest, abdomen, and pelvis (94.1%, n = 337/358). While radiologists were most likely to consider manifest hyperthyroidism an absolute contraindication to contrast media administration (43.8%, n = 14/32), most other groups of physicians opted for appropriate preparation before contrast media administration in this subset of septic patients. Conclusion In this survey, most participating physicians considered CT an essential diagnostic modality to detect an infectious focus in septic patients. Whereas the risk of ionizing radiation was regarded as justifiable by most physicians, different specialties varied in their assessment of the risks of contrast media administration. Key Points Physicians recognize CT as a relevant imaging modality in the diagnostic management of patients with sepsis. There is an interdisciplinary consensus that the use of ionizing radiation is justified in septic patients. There is disagreement about indications for and contraindications to contrast media administration among physicians from different medical specialties. Graphical Abstract |
| format | Article |
| id | doaj-art-634d9e392a7e4461b768785ff342c74f |
| institution | Kabale University |
| issn | 1869-4101 |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-634d9e392a7e4461b768785ff342c74f2025-01-19T12:26:14ZengSpringerOpenInsights into Imaging1869-41012025-01-0116111310.1186/s13244-024-01894-3Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsisMaria Isabel Opper Hernando0Denis Witham1Ann-Christine Stahl2Peter Richard Steinhagen3Stefan Angermair4Wolfgang Bauer5Friederike Compton6Andreas Edel7Jan Matthias Kruse8York Kühnle9Gunnar Lachmann10Susanne Marz11Holger Müller-Redetzky12Jens Nee13Oliver Paul14Damaris Praeger15Carsten Skurk16Miriam Stegemann17Alexander Uhrig18Stefan Wolf19Myrto Bolanaki20Kerstin Rubarth21Joachim Seybold22Elke Zimmermann23Marc Dewey24Julian Pohlan25Department of Radiology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1Department of Cardiology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1Department of Radiology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Charitéplatz 1Department of Anesthesiology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30Emergency Department, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30Medical Clinic with Focus on Nephrology and Internal Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1 and Augustenburger Platz 1Medical Clinic with Focus on Nephrology and Internal Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Augustenburger Platz 1Department of Cardiology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Augustenburger Platz 1Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Charitéplatz 1Interdisciplinary Anesthesiology and Surgical Intensive Care Unit, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1 and Augustenburger Platz 1Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1Medical Clinic with Focus on Nephrology and Internal Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Augustenburger Platz 1Department of Cardiology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Augustenburger Platz 1Clinic for Cardiology, Angiology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1Department of Cardiology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Augustenburger Platz 1Department of Infectious Diseases and Respiratory Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1Department of Neurosurgery with Pediatric Neurosurgery Unit, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1Emergency Department, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1 and Augustenburger Platz 1Institute of Biometry and Clinical Epidemiology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1Medical Directorate, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1Department of Radiology, Oberhavel Kliniken – Oberhavel Kliniken GmbH, Academic Teaching Hospital of the Charité - Universitätsmedizin BerlinDepartment of Radiology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1Department of Radiology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1Abstract Objectives To survey physicians’ views on the risks and benefits of computed tomography (CT) in the management of septic patients and indications for and contraindications to contrast media use in searching for septic foci. Methods A web-based questionnaire was administered to physicians at a large European university medical center in January 2022. A total of 371 questionnaires met the inclusion criteria and were analyzed with physicians’ work experience, workplace, and medical specialty as independent variables. Chi-square tests were used for exploratory analysis. Results While physicians with all levels of work experience were included, the largest group (35.0%, n = 130/371) had 3–7 years of experience. Most physicians agreed that the benefits of CT outweigh its potential adverse effects in septic patients (90.5%, n = 336/371). Responders saw the strongest indication for contrast media administration in septic patients for (1) CT examinations of the abdomen (92.7%, n = 333/359) and (2) combined CT examinations of the chest, abdomen, and pelvis (94.1%, n = 337/358). While radiologists were most likely to consider manifest hyperthyroidism an absolute contraindication to contrast media administration (43.8%, n = 14/32), most other groups of physicians opted for appropriate preparation before contrast media administration in this subset of septic patients. Conclusion In this survey, most participating physicians considered CT an essential diagnostic modality to detect an infectious focus in septic patients. Whereas the risk of ionizing radiation was regarded as justifiable by most physicians, different specialties varied in their assessment of the risks of contrast media administration. Key Points Physicians recognize CT as a relevant imaging modality in the diagnostic management of patients with sepsis. There is an interdisciplinary consensus that the use of ionizing radiation is justified in septic patients. There is disagreement about indications for and contraindications to contrast media administration among physicians from different medical specialties. Graphical Abstracthttps://doi.org/10.1186/s13244-024-01894-3Tomography (X-ray computed)SepsisSurveys and questionnairesClinical reasoningContrast media |
| spellingShingle | Maria Isabel Opper Hernando Denis Witham Ann-Christine Stahl Peter Richard Steinhagen Stefan Angermair Wolfgang Bauer Friederike Compton Andreas Edel Jan Matthias Kruse York Kühnle Gunnar Lachmann Susanne Marz Holger Müller-Redetzky Jens Nee Oliver Paul Damaris Praeger Carsten Skurk Miriam Stegemann Alexander Uhrig Stefan Wolf Myrto Bolanaki Kerstin Rubarth Joachim Seybold Elke Zimmermann Marc Dewey Julian Pohlan Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsis Insights into Imaging Tomography (X-ray computed) Sepsis Surveys and questionnaires Clinical reasoning Contrast media |
| title | Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsis |
| title_full | Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsis |
| title_fullStr | Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsis |
| title_full_unstemmed | Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsis |
| title_short | Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsis |
| title_sort | critical reflection on the indication for computed tomography an interdisciplinary survey of risk and benefit management in patients with sepsis |
| topic | Tomography (X-ray computed) Sepsis Surveys and questionnaires Clinical reasoning Contrast media |
| url | https://doi.org/10.1186/s13244-024-01894-3 |
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