CT Use in Hospitalized Pediatric Trauma Patients: 15-year Trends in a Level I Pediatric and Adult Trauma Center

Abstract

MPH Purpose:To evaluate the 15-year trend in the use of computed tomography (CT) in hospitalized pediatric trauma patients admitted to Harborview Medical Center (HMC) from 1996 to 2010. Materials and Methods:This Health Insurance Portability and Accountability Actcompliant retrospective study was approved by the institutional review board. The requirement for informed consent was waived. The HMC trauma registry was linked to the billing department data, and patient and injuryrelated characteristics were extracted, in addition to type and frequency of CT procedures. Patients discharged from the emergency department and patients hospitalized for less than 24 hours were not included in this study. Patients were classified into three categories according to age: 0-14 years, 15-18 years, and 19-54 years (reference group). Multivariate negative binomial regression was used to compare CT usage among different age groups by adjusting for patient sex, race and/or ethnicity, insurance status, mechanism of injury, injury severity, final disposition (dead vs alive), and year of admission. The trend for CT use in children and teenagers was also evaluated. Results:A total of 64 425 trauma patients 0-54 years of age were admitted during the study period. Conclusion:A decreasing or unchanged trend was observed in CT usage in hospitalized pediatric trauma patients in recent years.q RSNA, 2013

Frequency of paediatric medical imaging examinations performed at a European teaching hospital over a 7-year period

“…While we cannot truly determine whether such campaigns have really influenced the trends noted in our study, we must point out that only a limited number of studies have reported similar findings to this study [23,29,53,54]. Furthermore, our study appears to be the first to report such use trends across a 7-year period for various MI examinations performed on paediatric patients at an acute and general hospital in Europe.…”

Academic-community partnerships improve outcomes in pediatric trauma care

“…The most prominent finding in this study was the dramatic decrease in CT use for injured children treated after PTC designation, even when controlling for patient and injury specific variables. Current literature underscores the overuse of CT scans for injured children [19][20][21] and the link between CT use in the pediatric population and overall increased lifetime risk of cancer [22,23]. In response, multiple triage algorithms emphasizing monitored observation, plain radiography and decreased CT usage have been developed [24][25][26].…”

Computed Tomography and Shifts to Alternate Imaging Modalities in Hospitalized Children

“…Studies assessing the frequency of CT utilization in children during the past 2 decades demonstrated a large increase from the mid-1990s, [15][16][17][18][19][20][21][22] with some demonstrating either a plateau 16 or decline. 20,21 Previous studies were limited by focusing on a single institution 21 or a single condition.…”

“…20,21 Previous studies were limited by focusing on a single institution 21 or a single condition. 16,21 Furthermore, it is unknown whether changes reflect a decrease in overall imaging or a shift to alternate imaging modalities. The objectives of this multicenter study were to assess trends in CT utilization in hospitalized children and determine whether these changes are associated with shifts to alternate imaging modalities.…”