• Seán Cournane, Donnacha Creagh, Neil O'Hare, Niall Sheehy, and Bernard Silke.
• Medical Physics and Bioengineering Department, St James's Hospital, Dublin, Ireland. Electronic address: scournane@stjames.ie.
• J Am Coll Radiol. 2014 Jul 1; 11 (7): 698-702.

PurposeMRI is an important diagnostic tool for acute medical admissions. Its relevance to in-hospital mortality and length of stay (LOS) has been examined at St James's Hospital in Dublin, Ireland.MethodsAll patients admitted for medical emergencies from 2010 through 2012 were studied (18,534 episodes); any relationship between an MRI request, underlying diagnosis on any in-hospital death, and LOS was examined. Logistic regression with generalized estimating equations, adjusted for correlated observations (readmissions), odds ratio estimates, and zero-truncated Poisson regression for LOS were used.ResultsMRI procedures were requested in 8.6% of episodes. The in-hospital mortality rate was significantly higher when MRI was performed (7.8% vs 4.6%, P < .001). The unadjusted odds ratio for in-hospital death during that episode was 1.74 (95% confidence interval, 1.26-2.37; P < .001) compared with episodes without MRI. The hospital stay for those MRI episodes was longer (median, 9.1 days; interquartile range, 4.0-26.8 days) than for non-MRI episodes (median, 5.8 days; interquartile range, 2.2-12.2; P < .001). Each unit increase in MRI waiting time (cutoffs set at 0, 1, 3, 7, and 14 days) gave an estimated increase of 1.12 days in hospital LOS, adjusted for illness severity and comorbidities.ConclusionsMR imaging identified in a subgroup of emergency patients at higher risk of an in-hospital death. These patients have longer LOS attributable in part to procedure wait times, not merely to illness severity or comorbidities.Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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