Advanced radiological investigations and findings amongst community assault victims admitted to a tertiary South African hospital

Toit, F. Du; Griffith‐Richards, Stephanie; Zyl, Beulah Christina van; Pitcher, R

doi:10.17159/2078-5151/2019/v57n2a2972

Cited by 1 publication

(2 citation statements)

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“…CT of the brain was the most commonly ordered investigation overall. This is similar to findings from previous studies in South Africa conducted in Johannesburg and Cape Town [8,15]. In the Cape Town study, 90% of the assault victims required a CT brain [15].…”

Section: Discussionsupporting

confidence: 89%

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CT Utilization in a Level One Trauma Center in South Africa

Goldstein¹,

Dawadi²,

Viljoen³

2022

Cureus

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IntroductionComputed tomography (CT) imaging forms an important component in the evaluation and management of patients with traumatic injuries. Many South African emergency departments (EDs) have a significant trauma-related workload, especially in the public sector, where there are limitations in resources relating to CT scanners. It is important to gauge the impact of traumatic injuries on CT utilization. The primary objectives were to quantify the number and type of CT imaging studies trauma patients received, as well as to determine the frequency of radiologically significant findings in a level one trauma center. The secondary objectives were to determine the CT utilization rate and describe the demographics of patients who received imaging. MethodsThis was a retrospective, quantitative, descriptive, cross-sectional study undertaken over two months at the level one trauma center of a tertiary, academic, public sector teaching hospital in Johannesburg, South Africa. The radiology department's picture archiving and communication system (PACS) was used to evaluate the reports of trauma patients who were referred for a CT scan. The trauma center register was used to calculate the CT utilization rate. ResultsThere were 5,058 trauma patients seen in the two months. A total of 1,277 CT scans were performed on 843 patients. CT brain accounted for 52% of all scans performed. Radiologically significant findings were demonstrated in 407 scans (354 patients), i.e. 31.9% of scans and 42% of patients. CT chest and peripheral angiogram demonstrated radiologically significant findings in 60.5% and 50.9% of scans respectively. Assault accounted for 55.8% of the injuries sustained and road traffic accidents accounted for 33.2%. The overall CT utilization rate was 16.7% i.e. 843 out of the 5,058 trauma patients underwent a CT scan. ConclusionsSouth Africa has a substantial trauma burden which commonly necessitates CT utilization. It is concerning that blunt and penetrating assault continues to dominate these traumatic presentations. Worldwide, there is a broad range of described CT utilization rates and the findings at this level one trauma center fall within that range. ED clinicians are encouraged to continue carefully using this scarce resource in the trauma setting.

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Section: Discussionsupporting

confidence: 89%

“…This is similar to findings from previous studies in South Africa conducted in Johannesburg and Cape Town [8,15]. In the Cape Town study, 90% of the assault victims required a CT brain [15]. When head trauma is sustained, it can have devastating consequences.…”

Section: Discussionsupporting

confidence: 88%