Diagnostic abdominal imaging is frequently performed in hospitalized patients to assess the cause of abnormal liver function tests (LFTs).
In this study, a research team assessed whether the extent and severity of LFT abnormalities predicted the yield of inpatient imaging. Their findings are published in the November issue of the Journal of Evaluation in Clinical Practice.
The researchers retrospectively reviewed inpatients' abdominal imaging studies performed for abnormal LFTs, during a 27 month period.
|21% of patients with 0 or 1 abnormal LFT class had a positive imaging study.|
|Journal of Evaluation of Clinical Practice|
They matched imaging results to LFTs performed during a 5 day collection window surrounding the image request date.
In addition, 5 LFTs were categorized by severity of abnormality, and were then collapsed into 3 classes based on pathophysiology.
Of the 759 imaging studies completed for the indication of abnormal LFTs, only 26% explained the abnormal LFTs.
The research team found that severity of test abnormality correlated with positive imaging examinations only for the transaminases: 18% for the normal to mildly abnormal transaminases, compared with 31% for moderately to severely abnormal transaminases.
In addition, 21% of patients with 0 or 1 abnormal LFT class had a positive imaging study, compared with 35% of patients with all 3 abnormal LFT classes.
Dr Jeffrey Rothschild's team concluded, "The yield of inpatient abdominal imaging for abnormal LFTs correlates only weakly with both the severity and the extent of different abnormal LFTs".
"Further research is needed to define the optimal imaging strategies for evaluating inpatients with suspected hepatobiliary disease."