An analysis of trauma-related CT utilization and abnormal findings in emergency department: a one-year retrospective study

Abstract

Trauma is one of the major indications for admission to the emergency department (ED) and Computed Tomography (CT) scan requests. Understanding of CT utilization is important to reduce unnecessary imaging and radiation exposure. This study aimed to examine the utilization pattern of CT scans for trauma patients in the ED and how often traumatic abnormalities occurred. A retrospective study was conducted over a one-year period. Data for patients who were admitted to the ED and underwent CT scans for trauma indications, type of CT procedure performed, findings, and prior radiography were collected from the picture archiving and communication system. A total of 881 trauma patients underwent a CT scan as part of their investigation. Abnormalities were identified in 527 (59.9%) of cases and proportional with prior radiography [828 (94%)]. Different types of CT procedures were performed, as requested by the ED physicians, including 450 CT scans of the head, 188 for the spine, 93 for the chest, 45 CT CAP, 29 for the whole-body, 22 for the pelvis, 16 for the chest and abdomen, 13 for the extremities, and 11 for the abdomen. CT of the head was the most common procedure performed for trauma patients with 55% positive findings and may represent an opportunity for reduction of the use of CT scans, taking into consideration validated clinical decision rules. For multiple-trauma patients, a clearly defined criterion must be established to determine which CT procedure is required for these patients based on clinical indications and presentations. Therefore, for better radiation protection practices, a review and improvement of CT protocols, as well as justification and optimization, should be considered for utilization of CT scans for trauma patients.

Vers de nouvelles recommandations en radioprotection : la CIPR en marche / Towards new recommendations in radiological protection: ICRP on the move

“…Dans ce numéro de Radioprotection, et en lien avec l'exposition médicale, la justification des examens scanners est abordée, en pédiatrie (Tahiri et al, 2022) et aux urgences (Shubayr et Alomairy, 2022). De plus, le risque attribuable sur la vie entière apparaît plus précis que la dose efficace pour évaluer le risque dans le domaine de la cardiologie interventionnelle (Jamshidi et al, 2022).…”

“…In this issue of Radioprotection, and in line with medical exposure, the justification of CT examinations is addressed, in pediatrics (Tahiri et al, 2022) and in the emergency department (Shubayr and Alomairy, 2022). Moreover, the lifetime attributable risk appears more accurate than effective dose to evaluate the risk in interventional cardiology (Jamshidi et al, 2022).…”