217 Low-dose-CT versus X-ray in patients suspected of pulmonary disease ULDCT: Ultra-low-dose chest computed tomography, CXR: Chest X-ray, SD: standard deviation, IQR: interquartile range. a See Supplementary Table S5 for a detailed composition of this table including specification of variables. b Values are numbers (percentages) unless otherwise specified. c Variables included in the Charlson Comorbidity Index.23 d Charlson Comorbidity Index, excluding AIDS. Predicts 10-year survival in patients with multiple comorbidities.23 Management at the Emergency Department More patients in the ULDCT group had a clinical diagnosis of CAP at ED discharge: 255/1161 (22.0%) versus 189/1151 (16.4%), a difference of 5.5% (95% CI: 2.3% to 8.8%). In the ULDCT group, more patients had a diagnosis at ED discharge of (possible) influenza A/B (Table 2). The number of clinically relevant incidental findings was 100 (8.3%; 95% CI: 7.0 to 10.0) in the ULDCT group versus 14 (1.2 %; 95% CI: 1.0 to 2.0) in the CXR group (absolute difference 7.2; 95% CI: 5.5 to 8.9). The most frequently reported incidental findings were pulmonary nodules (ULDCT 54, CXR 7; Supplementary Table S2). In the ULDCT group 475/1208 patients (39.3%) had one or more additional imaging procedures within 28 days after the initial ULDCT, compared to 652/1210 (53.9%) in the CXR group after the initial CXR, an absolute difference of -14.6% (95% CI: -18.5% to -10.6%). In the ULDCT group median ED length of stay was 4:47h (IQR 3:39 to 6:21). For CXR median ED length of stay was 4:36h (IQR 3:22 to 6:14). In the ULDCT group 638/1208 (52.7%) patients were admitted to hospital, with a median hospital length of stay of 4.8 days (IQR 2.1 to 8.8). After CXR 659/1210 (54.5%) patients were admitted to hospital; their median hospital length of stay was 4.6 days (IQR 2.1 to 8.8). There was a significant difference in the median ED length of stay (0:14h IQR 0:04 to 0:23) in favour of ULDCT, there was no significant difference in the proportion admitted (1.7%; 95% CI: -0.06 to 0.02) or in the median hospital length of stay between both groups (0.04 days; 95% CI: -0.3 to 0.5). After ULDCT 50/1208 patients (4.1%) were admitted to the intensive care unit versus 44/1210 (3.6%) patients in the CXR group. 9
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