The utility of computed tomography at a district-level public hospital in Cape Town

Background: Computed tomography (CT) has become an invaluable aid in medical diagnostic workup, and its global usage has been shown to be consistently increasing across all departments. While typically located in regional or central hospitals in South Africa, its recent introduction at the district...

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Main Authors: Ridwaan Osman, Amy Fouten, Nihaad Jacobs, Fawwaz Cader, Francois Ehlers, Nazrana Zalgaonkir, Elaine Erasmus, Daniël van Hoving
Format: Article
Language:English
Published: AOSIS 2024-05-01
Series:South African Family Practice
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Online Access:https://safpj.co.za/index.php/safpj/article/view/5891
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author Ridwaan Osman
Amy Fouten
Nihaad Jacobs
Fawwaz Cader
Francois Ehlers
Nazrana Zalgaonkir
Elaine Erasmus
Daniël van Hoving
author_facet Ridwaan Osman
Amy Fouten
Nihaad Jacobs
Fawwaz Cader
Francois Ehlers
Nazrana Zalgaonkir
Elaine Erasmus
Daniël van Hoving
author_sort Ridwaan Osman
collection DOAJ
description Background: Computed tomography (CT) has become an invaluable aid in medical diagnostic workup, and its global usage has been shown to be consistently increasing across all departments. While typically located in regional or central hospitals in South Africa, its recent introduction at the district level has many foreseeable benefits. We evaluated its utility at one of the first district hospitals in the Western Cape to obtain a CT suite. Objectives: This study aimed to describe the type of CT scans ordered, the clinical indications, the prevalence of significant abnormal findings and the agreement between the clinical opinion and radiological diagnosis. Methods: A descriptive cross-sectional study was conducted over a 1-year period at Khayelitsha Hospital, an entry-level hospital just outside of Cape Town. Results: A total of 3242 CT scans were analysed. The mean age of patients was 46 years; 51.4% were males. A mean of 13 scans were performed per working day. The head and neck area were the most scanned region (n = 1841, 52.3%). Predominantly requested by the Emergency Centre (n = 1382, 42.6%), indications were mainly for general medical conditions workup (n = 2151, 66.4%). Most scans showed abnormalities (n = 2710, 83.6%), with 2115 (65.2%) considered relevant (‘positive yield’). Clinical and CT diagnoses agreed in 1610 (49.7%) cases. Conclusion: Computed tomography usage at the district level demonstrated positive yield rates comparable to that of tertiary centres. This implies an appropriate utilisation of the service with a potential decrease in the burden on the referral centre. Contribution: Computed tomography scanners at district-level facilities are appropriately utilised and can provide greater access to care while potentially decreasing the burden on referral centres.
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spelling doaj-art-e63f35a80e76418d9716d1233e5b29532025-08-20T04:03:12ZengAOSISSouth African Family Practice2078-61902078-62042024-05-01661e1e610.4102/safp.v66i1.58914431The utility of computed tomography at a district-level public hospital in Cape TownRidwaan Osman0Amy Fouten1Nihaad Jacobs2Fawwaz Cader3Francois Ehlers4Nazrana Zalgaonkir5Elaine Erasmus6Daniël van Hoving7Department of Health, Faculty of Emergency Medicine, Khayelitsha District Hospital, Cape TownDepartment of Health, Faculty of Emergency Medicine, Khayelitsha District Hospital, Cape TownDepartment of Health, Faculty of Emergency Medicine, Khayelitsha District Hospital, Cape TownDepartment of Health, Faculty of Emergency Medicine, Khayelitsha District Hospital, Cape TownDepartment of Health, Faculty of Emergency Medicine, Khayelitsha District Hospital, Cape TownDepartment of Health, Faculty of Emergency Medicine, Khayelitsha District Hospital, Cape TownDivision of Emergency Medicine, Stellenbosch University, Cape TownDivision of Emergency Medicine, Stellenbosch University, Cape TownBackground: Computed tomography (CT) has become an invaluable aid in medical diagnostic workup, and its global usage has been shown to be consistently increasing across all departments. While typically located in regional or central hospitals in South Africa, its recent introduction at the district level has many foreseeable benefits. We evaluated its utility at one of the first district hospitals in the Western Cape to obtain a CT suite. Objectives: This study aimed to describe the type of CT scans ordered, the clinical indications, the prevalence of significant abnormal findings and the agreement between the clinical opinion and radiological diagnosis. Methods: A descriptive cross-sectional study was conducted over a 1-year period at Khayelitsha Hospital, an entry-level hospital just outside of Cape Town. Results: A total of 3242 CT scans were analysed. The mean age of patients was 46 years; 51.4% were males. A mean of 13 scans were performed per working day. The head and neck area were the most scanned region (n = 1841, 52.3%). Predominantly requested by the Emergency Centre (n = 1382, 42.6%), indications were mainly for general medical conditions workup (n = 2151, 66.4%). Most scans showed abnormalities (n = 2710, 83.6%), with 2115 (65.2%) considered relevant (‘positive yield’). Clinical and CT diagnoses agreed in 1610 (49.7%) cases. Conclusion: Computed tomography usage at the district level demonstrated positive yield rates comparable to that of tertiary centres. This implies an appropriate utilisation of the service with a potential decrease in the burden on the referral centre. Contribution: Computed tomography scanners at district-level facilities are appropriately utilised and can provide greater access to care while potentially decreasing the burden on referral centres.https://safpj.co.za/index.php/safpj/article/view/5891computed tomographyemergency medicinefamily medicineprimary healthcareradiologydistrict hospitalyield
spellingShingle Ridwaan Osman
Amy Fouten
Nihaad Jacobs
Fawwaz Cader
Francois Ehlers
Nazrana Zalgaonkir
Elaine Erasmus
Daniël van Hoving
The utility of computed tomography at a district-level public hospital in Cape Town
South African Family Practice
computed tomography
emergency medicine
family medicine
primary healthcare
radiology
district hospital
yield
title The utility of computed tomography at a district-level public hospital in Cape Town
title_full The utility of computed tomography at a district-level public hospital in Cape Town
title_fullStr The utility of computed tomography at a district-level public hospital in Cape Town
title_full_unstemmed The utility of computed tomography at a district-level public hospital in Cape Town
title_short The utility of computed tomography at a district-level public hospital in Cape Town
title_sort utility of computed tomography at a district level public hospital in cape town
topic computed tomography
emergency medicine
family medicine
primary healthcare
radiology
district hospital
yield
url https://safpj.co.za/index.php/safpj/article/view/5891
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