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Radiation Exposure from Diagnostic Imaging Studies Among Patients with Inflammatory Bowel Disease in a Safety-Net Health-Care System

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Abstract

Background/Aims

Radiographic imaging studies are important in the management of patients with inflammatory bowel disease (IBD), but are associated with radiation exposure. IBD patients in a safety-net health-care system may be at risk of high exposure to radiation. Our purpose was to identify associations of high-dose radiation exposure among an ethnically diverse cohort of IBD patients in a safety-net health-care system.

Methods

A study was performed on patients with IBD receiving care from the Harris County Hospital District. Radiation exposure was calculated using total number of imaging studies performed between from 2000 and 2010 and estimates of radiation dose per study. Associations of high-dose radiation exposure, defined as a cumulative effective dose (CED) >50 mSv, were identified by using univariate and multivariate logistic regression.

Results

The study cohort of 278 patients with IBD was ethnically diverse, with 30 % Caucasian, 44 % African–American, and 26 % Hispanic. The median CED was 10.40 mSv (SD 20.02). Annualized radiation doses were 3.45 mSv/year among patients with Crohn’s disease (CD) and 1.27 mSv/year among patients with ulcerative colitis, p < 0.02. Approximately 13 % of IBD patients received a CED >50 mSv. There were no differences in radiation exposure based on age, gender, or race/ethnicity.

Conclusions

A small proportion of IBD patients in a safety-net health-care system received high doses of diagnostic radiation exposure. Use of diagnostic imaging studies that limit radiation exposure should be encouraged.

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Abbreviations

IBD:

Inflammatory bowel disease

CD:

Crohn’s disease

UC:

Ulcerative colitis

HCHD:

Harris County Hospital District

CED:

Cumulative effective dose

EMR:

Electronic medical records

ICD-9:

International classification of diseases, 9th revision

CI:

Confidence interval

OR:

Odds ratio

mSv:

Millisieverts

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Acknowledgments

The research reported here was supported in part by the Houston VA HSR&D Center of Excellence (HFP90-020) and the American College of Gastroenterology Junior Faculty Development Award to J.K. Hou and by UCB Pharmaceuticals to S. Thirumurthi.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Houston VA HSR&D Center of Excellence; Michael E. DeBakey Veterans Affairs Hospital, 1709 Dryden Road, Suite 8.40, MS: BCM 620, Houston, TX, 77030, USA

    Jason K. Hou

  2. Baylor College of Medicine, Houston, TX, USA

    Jason K. Hou, Hoda M. Malaty & Selvi Thirumurthi

Authors
  1. Jason K. Hou
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  2. Hoda M. Malaty
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  3. Selvi Thirumurthi
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Corresponding author

Correspondence to Jason K. Hou.

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The views expressed in this article are those of the author(s) and do not necessarily represent the views of the Department of Veterans Affairs.

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Hou, J.K., Malaty, H.M. & Thirumurthi, S. Radiation Exposure from Diagnostic Imaging Studies Among Patients with Inflammatory Bowel Disease in a Safety-Net Health-Care System. Dig Dis Sci 59, 546–553 (2014). https://doi.org/10.1007/s10620-013-2852-1

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  • DOI: https://doi.org/10.1007/s10620-013-2852-1

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