View in EDS

Clinically Significant Neuroimaging Findings Among Pediatric Patients Presenting to the Emergency Department With Symptoms of Psychosis: A Multicenter Retrospective Study

Saved in:
Bibliographic Details
Title: Clinically Significant Neuroimaging Findings Among Pediatric Patients Presenting to the Emergency Department With Symptoms of Psychosis: A Multicenter Retrospective Study
Authors: Jennifer A. Hoffmann, Tapan K. Parikh, Doug Lorenz, Michael P. Goldman, Emily M. Powers, Shilpa J. Patel, Ilana S. Lavina, Theodore W. Heyming, Jasmin T. England, Mohsen Saidinejad, Ilene Claudius, Pallavi Ghosh, Daniel J. Shapiro, Tricia B. Swan, Kamali L. Bouvay, Eileen Murtagh Kurowski, Nadine M. Smith, Justin R. Davis, Alexander B. Moxam, Eli J. Muhrer, Rohit P. Shenoi, Elyse N. Portillo, Ron L. Kaplan, Neil G. Uspal, Robert M. Lapus, Andrea T. Vo, Daniel B. Fenster, Danielle B. Barrocas, Deborah R. Liu, Pradip P. Chaudhari, Rachel Cafferty, Stephen B. Freedman, Jerri A. Rose, Megan F. Evers, Ashley M. Metcalf, Fareed Saleh, Jennifer Dunnick, Raymond D. Pitetti, Yashas R. Nathani, Muhammad Waseem, Todd A. Florin
Source: Academic Emergency Medicine.
Publisher Information: Wiley, 2025.
Publication Year: 2025
Description: BackgroundThe clinical utility of diagnostic neuroimaging for pediatric patients presenting to the emergency department (ED) for psychosis remains unclear. We sought to estimate the prevalence of and characteristics associated with clinically significant neuroimaging findings among pediatric patients presenting to the ED with symptoms of psychosis who had neuroimaging performed.MethodsThis retrospective cross‐sectional study included visits by patients 5 to ResultsClinically significant neuroimaging findings were identified in 5.4% (95% CI 4.2%, 6.9%) of 1118 ED visits (54% male, median [IQR] 14 [11–16] years old). Clinically significant findings occurred in 4.9% (34/699) of head computed tomography scans and 7.5% (45/604) of brain magnetic resonance imaging studies (p = 0.07). In a model that imputed missing data, no presenting features were associated with clinically significant neuroimaging findings. In a model that treated missing documentation as absence of the clinical feature, the adjusted odds of clinically significant neuroimaging findings were lower among ED visits by patients with suspected alcohol or substance use (aOR 0.38, 95% CI 0.16, 0.87).ConclusionAmong pediatric patients presenting to the ED with symptoms of psychosis who had neuroimaging obtained, approximately 1 in 20 had clinically significant findings. Suspected alcohol or substance use was associated with lower odds of clinically significant neuroimaging findings, although this finding was not consistent across modeling approaches. Prospective studies are needed to definitively evaluate the utility of neuroimaging among children and adolescents presenting to the ED with symptoms of psychosis.
Document Type: Article
Language: English
ISSN: 1553-2712
1069-6563
DOI: 10.1111/acem.70155
Rights: CC BY
Accession Number: edsair.doi...........c77fb6d81cb0ea2300851ce72c181d9e
Database: OpenAIRE
Description
Abstract:BackgroundThe clinical utility of diagnostic neuroimaging for pediatric patients presenting to the emergency department (ED) for psychosis remains unclear. We sought to estimate the prevalence of and characteristics associated with clinically significant neuroimaging findings among pediatric patients presenting to the ED with symptoms of psychosis who had neuroimaging performed.MethodsThis retrospective cross‐sectional study included visits by patients 5 to ResultsClinically significant neuroimaging findings were identified in 5.4% (95% CI 4.2%, 6.9%) of 1118 ED visits (54% male, median [IQR] 14 [11–16] years old). Clinically significant findings occurred in 4.9% (34/699) of head computed tomography scans and 7.5% (45/604) of brain magnetic resonance imaging studies (p = 0.07). In a model that imputed missing data, no presenting features were associated with clinically significant neuroimaging findings. In a model that treated missing documentation as absence of the clinical feature, the adjusted odds of clinically significant neuroimaging findings were lower among ED visits by patients with suspected alcohol or substance use (aOR 0.38, 95% CI 0.16, 0.87).ConclusionAmong pediatric patients presenting to the ED with symptoms of psychosis who had neuroimaging obtained, approximately 1 in 20 had clinically significant findings. Suspected alcohol or substance use was associated with lower odds of clinically significant neuroimaging findings, although this finding was not consistent across modeling approaches. Prospective studies are needed to definitively evaluate the utility of neuroimaging among children and adolescents presenting to the ED with symptoms of psychosis.
ISSN:15532712
10696563
DOI:10.1111/acem.70155