Efficiency of the Imaging Strategy for the Management of Pneumonia

NCT ID: NCT05140408

Last Updated: 2022-01-12

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 2240 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2021-05-01
• Study Completion Date: 2022-01-31

Brief Summary

For patients with suspected pneumonia presenting to the emergency room, the imaging strategy most often involves a frontal and lateral chest x-ray despite poor diagnostic input. Indeed, the radiography is not very sensitive and specific for the diagnosis of pneumopathy compared to the scanner. However, the scanner remains the gold standard, the major constraint of which concerns the irradiation to which the patient is exposed. The new scanners allow ultra-low-dose scans with better sensitivity than standard radiography with an equivalent dose of radiation. In addition, the ultra-low-dose scanner helps prevent diagnostic errors and unintended treatments. A low-dose CT scan for suspected pneumonia has been possible in the Strasbourg emergency department since March 2019. The investigators therefore hypothesize that a diagnostic strategy involving the performance of a low dose CT scan in the event of suspicion of pneumopathy in the emergency room makes it possible to improve the adequacy of the diagnosis made by the initial imaging examination and the diagnosis on discharge from hospitalization, to reduce respiratory or hemodynamic complications and to reduce the prescription of antibiotic therapy that is not suitable for the patient. course of the imaging result validated by a panel of emergency physicians and infectious disease specialists based on medical records in accordance with the recommendations.

Conditions

Pneumonia

Study Design

• Observational Model Type: CASE_ONLY
• Study Time Perspective: RETROSPECTIVE

Eligibility Criteria

Inclusion Criteria

• Major subject (≥18 years old)
• Emergency consultant subject with a final diagnosis of pneumonia, diagnostic code J18 and J15 with imaging: standard radiography or low dose scanner from 03/01/2019 to 02/29/2020
• Subject not having expressed their opposition, after information, to the reuse of their data for the purposes of this research

Exclusion Criteria

• Subject having expressed opposition to participating in the study
• Absence of emergency imaging
• Subject under guardianship or guardianship
• Subject under safeguard of justice

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University Hospital, Strasbourg, France

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Service d'Accueil des Urgences - Hôpitaux Universitaires de Strasbourg

Strasbourg, , France

Site Status: RECRUITING

Countries

France

Central Contacts

Sabrina GARNIER KEPKA, MD

Role: CONTACT

Sabrina.GARNIER-KEPKA@chru-strasbourg.fr

33 3 69 55 13 35

Saïd CHAYER, PhD, HDR

Role: CONTACT

said.chayer@chru-strasbourg.fr

Facility Contacts

Sabrina GARNIER KEPKA, MD

Role: primary

Sabrina.GARNIER-KEPKA@chru-strasbourg.fr

33 3 69 55 13 35

Saïd CHAYER, PhD, HDR

Role: backup

said.chayer@chru-strasbourg.fr

References

Kepka S, Zarca K, Ohana M, Hoffbeck L, Heimann C, Borgne PL, Severac F, Muller J, Sauleau EA, Bilbault P, Zaleski ID. Cost effectiveness of imaging strategies in the emergency department for the diagnostic workup of community-acquired pneumonia: a real-life retrospective study. Health Econ Rev. 2025 May 20;15(1):41. doi: 10.1186/s13561-025-00625-8.

Reference Type: DERIVED

PMID: 40392398 (View on PubMed)

Other Identifiers

8129

Identifier Type: -

Identifier Source: org_study_id