Emergency Physician Gender And Head Computed Tomography Orders For Older Adults Who Have Fallen

Authors

Rhys Kraft, Queen's University, Kingston, Ontario, Canada.
Mathew Mercuri, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Natasha Clayton, Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada.
Andrew Worster, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Eric Mercier, Centre de Recherche du CHU de Québec, Université Laval, Québec, Quebec, Canada.
Marcel Emond, Centre de Recherche du CHU de Québec, Université Laval, Québec, Quebec, Canada.
Catherine Varner, Schwartz/Reisman Emergency Medicine Institute, Sinai Health, Toronto, Ontario, Canada.
Shelley L. McLeod, Schwartz/Reisman Emergency Medicine Institute, Sinai Health, Toronto, Ontario, Canada.
Debra Eagles, Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Ian Stiell, Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.
David Barbic, Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Judy Morris, Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Québec, Canada.
Rebecca Jeanmonod, Emergency Medicine, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA.
Yoan K. Kagoma, Department of Radiology, McMaster University, Hamilton, Ontario, Canada.
Ashkan Shoamanesh, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Paul T. Engels, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Sunjay Sharma, Division of Neurosurgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Alexandra Papaioannou, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Sameer Parpia, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Ian Buchanan, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Mariyam Ali, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Kerstin De Wit, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Document Type

Article

Publication Title

Emergency Physician Gender and Head Computed Tomography Orders for Older Adults Who Have Fallen

Abstract

Objective: Physicians vary in their computed tomography (CT) scan usage. It remains unclear how physician gender relates to clinical practice or patient outcomes. The aim of this study was to assess the association between physician gender and decision to order head CT scans for older emergency patients who had fallen.

Methods: This was a secondary analysis of a prospective observational cohort study conducted in 11 hospital emergency departments (EDs) in Canada and the United States. The primary study enrolled patients who were 65 years and older who presented to the ED after a fall. The analysis evaluated treating physician gender adjusted for multiple clinical variables. Primary analysis used a hierarchical logistic regression model to evaluate the association between treating physician gender and the patient receiving a head CT scan. Secondary analysis reported the adjusted odds ratio (OR) for diagnosing intracranial bleeding by physician gender.

Results: There were 3663 patients and 256 physicians included in the primary analysis. In the adjusted analysis, women physicians were no more likely to order a head CT than men (OR 1.26, 95% confidence interval 0.98-1.61). In the secondary analysis of 2294 patients who received a head CT, physician gender was not associated with finding a clinically important intracranial bleed.

Conclusions: There was no significant association between physician gender and ordering head CT scans for older emergency patients who had fallen. For patients where CT scans were ordered, there was no significant relationship between physician gender and the diagnosis of clinically important intracranial bleeding.

First Page

1006

Last Page

1013

DOI

10.1111/acem.14928

Publication Date

Spring 4-21-2024

Recommended Citation

Kraft, Rhys; Mercuri, Mathew; Clayton, Natasha; Worster, Andrew; Mercier, Eric; Emond, Marcel; Varner, Catherine; McLeod, Shelley L.; Eagles, Debra; Stiell, Ian; Barbic, David; Morris, Judy; Jeanmonod, Rebecca; Kagoma, Yoan K.; Shoamanesh, Ashkan; Engels, Paul T.; Sharma, Sunjay; Papaioannou, Alexandra; Parpia, Sameer; Buchanan, Ian; Ali, Mariyam; and De Wit, Kerstin, "Emergency Physician Gender And Head Computed Tomography Orders For Older Adults Who Have Fallen" (2024). Department of Emergency Medicine @SLUHN Articles & Publications. 20.
https://crin.sluhn.org/emergmed_ap/20