Using the claustrophobia questionnaire to pre-detect claustrophobia in MRI patients and assess its financial impact in a state general hospital in Malta

Abstract

Purpose: Claustrophobic patients are prone to experience a feeling of confinement during their MRI examination, resulting in terminations and reappointments which could potentially lead to a financial loss. The literature indicated that the CLQ might be a good tool to pre-detect claustrophobia. In Malta no study has been conducted using such a tool, moreover the financial aspect of claustrophobia due to terminations and reappointments was never determined locally.

Objectives: The objectives of the study, were to (a) establish the possible risk factors that could have increased the likelihood of patients suffering from claustrophobia, potentially leading to the early termination of their examination (b) to use the CLQ in order to investigate if a patient about to undergo an MRI exam had the potential to develop claustrophobia during the scan (c) to determine the financial cost of claustrophobia.

Methodology: A total of 191 participants were enrolled prospectively in the study. Data collection was performed between February 2019 to March 2019, in a state general hospital in Malta. The data was gathered by the means of the CLQ and a checklist. The Chi-Square test was used in order to test for statistical significance. Logistic regression was used to establish the claustrophobic cut off values.

Results: Among the 191 participants, a total of 17 patients (8.9%) suffered from claustrophobia during their MRI examination. No statistical significance was found when comparing the incidence of claustrophobia to gender (p=0.082), age (p=0.710), type of MRI examination (p=0.286), the scanning orientation (p=0.710) and to the patients’ occupational class (p=0.477). The suffocation subscale, restriction subscale and the total CLQ scale were significant predictors of claustrophobia since all the p values were 0. The best predictor of claustrophobia was the CLQ total score. The total financial cost due to claustrophobia in the current study amounted to €21,896.04.

Conclusion: The CLQ was a good tool to detect patients who were the most likely to terminate their MRI scan prematurely due to claustrophobia if the score was higher than the CLQ total score cut off value. Additionally, this tool has to be used with caution in the clinical area since this study indicated that the CLQ cannot detect individual patients who needed coping mechanisms if the score was lower than the cut off value.