For Unintended Weight Loss, CT Provides Valuable Diagnosis

March 10, 2021
Whitney J. Palmer

Scans are useful in identifying causes of nearly half of patients in the emergency department who have unintentional weight loss.

Pinpointing the cause of unintentional weight loss can be a tall order, but CT scans can help shed light on the cause with patients who present to the emergency room.

In a study published recently in Emergency Radiology, investigators from University Hospitals Cleveland Medical Center/Case Western Research University revealed that CT can provide an answer is nearly half of cases.

Although unexplained weight loss is not a common presentation in the emergency department, the team said, existing research indicates that 5 percent to 7 percent of adults nationwide seek help for the problem in this setting each year. Consequently, it is critical emergency providers better understand the role CT can play in helping them triage patients.

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“Our findings indicate that CT is a useful first-line imaging approach for the identification of organic causes of [unintentional weight loss,] with a true-positive rate of 48.8 percent,” the team said. “The use of CT scanning in the evaluation of UWL in the ED yielded a diagnosis in approximately half of all cases, indicating good diagnostic value.”

As part of their retrospective study, the team included 133 patients who had chest, abdomen, or pelvis CT scans in their emergency department between 2004 and 2020. Based on their analysis, CT made 65 true-positive detections – 41 cases of non-malignant gastrointestinal conditions (30 percent) and 30 cases of cancer (23 percent). In addition, their evaluation revealed that elevated white blood cell counts and physical exam irregularities were also significantly associated with CT abnormalities.

These results outpace existing literature, the team said. Four additional studies have looked at the same issue, but each time the true-positive rates have never climbed above 33.5 percent. Multiple factors could be at play, they said, noting the higher number of CT findings in this group of patients who exhibited more serious illness.

Ultimately, the authors said, even though additional research is needed, emergency providers should consider CT when presented with undifferentiated patients who comes to the department with unintentional weight loss. They suggested a study that implements a standard chest/abdomen/pelvis CT protocol with emergency department patients who have unintentional weight loss based on clinical and laboratory findings.

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