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Master Thesis

Intérêt du scanner thoraco-abdomino-pelvien dans les syndromes inflammatoires inexpliqués du sujet âgé

Abstract : Introduction: the atypical clinical presentation as well as the high frequency of an increased plasmatic C reactive protein (CRP) of unknown origin are frequent in older patients and make diagnosis difficult to be raised. The interest of a systematic Chest, abdomen and pelvis (CAP) Computed Tomography (CT)-scan needs to be assessed in those situations. Objective: to determine the proportion of CAP CT scans performed for an increased plasmatic CRP level of unknown origin that contribute to the diagnosis. Material and methods: we conducted an observational prospective study at Bordeaux University Hospital between January 2019 and June 2020. All consecutive hospitalized patients aged ≥75 years that underwent a CAP CT scan for an inflammatory syndrome of unknown origin (CRP > 5mg/L) were enrolled. Clinical data were collected the day the CT scan was ordered. Factors associated with a useful CT scan and the prevalence of incidentalomas were reported. Results: among the 100 enrolled patients (mean age 86 ± 5,7 years, 48 % female), the CAP CT scan allow the physician to raise the diagnosis up for 56 patients, mainly pulmonary infections (n=24) and abdominal infections (n=7). The only factor associated with a helpful CT scan was the high level of CRP. The most frequent reported incidentalomas were pleural effusion (n = 35), cysts (n=29) and prior bone fractures (n= 27). Conclusion: in this pilot study, CT scan seems to be a useful tool to explore unexplained inflammatory syndrome in older patients hospitalized in acute geriatric units.
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https://dumas.ccsd.cnrs.fr/dumas-02985732
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Submitted on : Monday, November 2, 2020 - 2:19:56 PM
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Amir Redjai. Intérêt du scanner thoraco-abdomino-pelvien dans les syndromes inflammatoires inexpliqués du sujet âgé. Sciences du Vivant [q-bio]. 2020. ⟨dumas-02985732⟩

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