Abstract 998: The Average Ionizing Radiation Exposure to Patients Admitted With Acute Myocardial Infarction in 2008
Background: Several billion imaging studies are performed worldwide each year, of which at least one-third are cardiovascular procedures. Between 1980 and 2006, it is estimated that there has been a greater than 700% increase in the collective dose received from radiation.
Methods: For every patient presenting in 2008 with an acute myocardial infarction (AMI) to one of 55 US academic hospitals enrolled in the University HealthSystem Consortium (UHC), we examined the number of each of the following diagnostic procedures involving ionizing radiation that were performed: Chest radiograph, CT chest, CT body, CT head, nuclear rest/stress perfusion, nuclear MUGA, nuclear ventilation/perfusion scan and cardiac catheterization. We estimated the average cumulative effective radiation dose during a single admission for AMI per patient admitted in 2008, based on typical effective radiation doses for imaging procedures published in a recent science advisory by the AHA Committee on Cardiac Imaging.
Results: In 2008, 35,707 patients (14,002 women and 21,705 men) were admitted for AMI to one of 55 academic hospitals enrolled in the UHC. A total of 248,822 procedures involving ionizing radiation were performed on these patients. On average, 7 imaging studies involving ionizing radiation were performed and an average cumulative effective radiation dose of 17.31 mSv was delivered per patient per AMI admission.
Conclusions: On average, the cumulative effective radiation dose per AMI admission was approximately 17 mSV, which corresponds to 850 chest radiographs. This represents over five and half times the annual US background radiation (3 mSv, 150 CXRs) and over one-third of the 50 mSv (2500 CXRs) annual limit for radiation workers. Rather than radiation exposure per imaging test, future studies should consider efforts at reducing total exposure by admitting diagnosis.