Incidental CT Findings in Trauma Patients: Incidence and Implications for Care of the Injured

Paluska, Thomas R; Sise, Michael J.; Sack, Daniel I.; Sise, C. Beth; Egan, Michael C; Biondi, Michael

doi:10.1097/01.ta.0000249129.63550.cc

Cited by 125 publications

(146 citation statements)

References 11 publications

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“…Our finding of a rate of incidental findings of 33.4% is similar to that found in previous studies [4,5]. However, the rate we observed in abdominal CT scans (56.3%) was higher even than the highest rate previously reported (45%) [8].…”

Section: Discussioncontrasting

confidence: 42%

“…While some of these incidental findings are benign and require no followup, others require serial imaging and close supervision of the patient by their primary care physician [3]. Prior studies have examined rates of incidental findings in trauma patients, a group that receives large amounts of CT scans in their workup [4][5][6][7], and renal colic patients [8]. Rates of incidental findings varied from 34% to 43% on abdominal CT scans in trauma patients [4][5][6], and up to 45% in renal colic ED patients [8].…”

Section: Introductionmentioning

confidence: 99%

“…Prior studies have examined rates of incidental findings in trauma patients, a group that receives large amounts of CT scans in their workup [4][5][6][7], and renal colic patients [8]. Rates of incidental findings varied from 34% to 43% on abdominal CT scans in trauma patients [4][5][6], and up to 45% in renal colic ED patients [8]. Rates of proper documentation and referral for followup of incidental findings in these groups has varied from 21% to 27% [7,8].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

169: Incidental Findings on CT Scans In the Emergency Department

Thompson

Wojcik

et al. 2010

Annals of Emergency Medicine

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Section: Discussioncontrasting

confidence: 42%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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169: Incidental Findings on CT Scans In the Emergency Department

Thompson

Wojcik

et al. 2010

Annals of Emergency Medicine

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“…There are plenty of studies evaluating incidental findings on CTs of trauma patients, but those include mainly thoracic, abdominal and cranial abnormalities. [2][3][4][5][6][7] To the best of our knowledge, there is just one study in the literature where the incidental cervical CT findings of trauma patients were regularly evaluated. 8 In this study, mainly osseous abnormalities and traumatic soft-tissue abnormalities were investigated.…”

Section: Introductionmentioning

confidence: 99%

The prevalence and clinical importance of incidental soft-tissue findings in cervical CT scans of trauma population

Ergün¹,

Lakadamyalı²

2013

Dentomaxillofacial Radiology

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Objectives: To define the age-related prevalence of incidental soft-tissue findings in cervical CT scans of a trauma population and to investigate their clinical importance. Methods: The original diagnostic radiology reports and the CT images of the 357 patients with cervical trauma were retrospectively evaluated. Incidental soft-tissue findings were investigated. All findings were grouped according to age. The findings were classified based on their clinical importance into three categories: Category 1: no clinical importance, Category 2: possible clinical importance requiring further investigation and Category 3: obvious clinical importance. In addition, the medical records of the patients were investigated. The follow-up ratio of the pathologies mentioned in the original radiology report was recorded. Results: The most frequently encountered findings in Categories 2 and 3 were carotid artery calcification (n 5 89, 24.9%) and tonsillolith (n 5 115, 32.2%), respectively. The reporting ratio in the original reports of Categories 1, 2 and 3 findings was 1.1% (n 5 4), 9% (n 5 27) and 34.5% (n 5 64), respectively. No further investigations and follow-up was accomplished for Category 1 lesions, whereas 11.1% of Category 2 and 35.9% of Category 3 lesions were subjected to further investigations and follow-up. Conclusions: The cervical CT scans of trauma patients reveal many clinically important softtissue incidental findings. Cervical region incidental findings may be followed up on an outpatient basis, rarely being of life-threatening value. The ratio of reporting and follow-up of incidental findings increases parallel to the clinical importance of the lesions.

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“…Studies of trauma patients with incidental findings detected on imaging have confirmed lower rates of both documentation (15-48%) and follow-up (49%) (27,28). This is likely due to poor communication between health care systems as well as between providers and patients.…”

Section: Strengths and Limitationsmentioning

confidence: 98%

What’s in a Name? Factors Associated with Documentation and Evaluation of Incidental Pulmonary Nodules

Iqbal

Stott²,

Huml³

et al. 2016

Annals ATS

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Rationale: Radiologist reports of pulmonary nodules discovered incidentally on computed tomographic (CT) images of the chest may influence subsequent evaluation and management.Objectives: We sought to determine the impact of the terminology used by radiologists to report incidental pulmonary nodules on subsequent documentation and evaluation of the nodules by the ordering or primary care provider. Methods:We conducted a retrospective cohort study of patients with incidentally discovered pulmonary nodules detected on CT chest examinations performed during 2010 in a large urban safety net medical system located in northeastern Ohio. Measurements and Main Results:Twelve different terms were used to describe 344 incidental pulmonary nodules. Most nodules (181 [53%]) were documented in a subsequent progress note by the provider, and 140 (41%) triggered subsequent clinical activity. In a multivariable analysis, incidental pulmonary nodules described in radiology reports using the terms density (odds ratio [OR], 0.06; 95% confidence interval [CI], 0.01-0.47), granuloma (OR, 0.07; 95% CI, 0.01-0.65), or opacity (OR, 0.09; 95% CI, 0.01-0.68) were less likely to be documented by the provider than those that used the term mass. Patients with nodules described in radiology reports using the term nodule (OR, 0.15; 95% CI, 0.02-0.99), nodular density (OR, 0.09; 95% CI, 0.01-0.63), granuloma (OR, 0.06; 95% CI, 0.01-0.69), or opacity (OR, 0.05; 95% CI, 0.01-0.43) were less likely to receive follow-up than were patients with nodules described using the term mass. The factor most strongly associated with follow-up of pulmonary nodules was documentation by the provider (OR, 5.85; 95% CI, 2.93-11.7).Conclusions: Within one multifacility urban health system in the United States, the terms used by radiologists to describe incidental pulmonary nodules were associated with documentation of the nodule by the ordering physician and subsequent follow-up. Standard terminology should be used to describe pulmonary nodules to improve patient outcomes.Keywords: solitary pulmonary nodule; multiple pulmonary nodules; CT scan; clinical decision making Author Contributions: Full access to all of the data in the study and responsibility for the integrity of the data and the accuracy of the data analysis: J.D.T.; study conception and design; collection and assembly of data; analysis and interpretation of the data; critical revision of the manuscript for important intellectual content; and administrative, technical, or material support: all authors; drafting of the manuscript: M.N.I., E.S., A.M.H., V.K., and J.D.T.; statistical expertise: A.M.H., V.K., C.S., and J.D.T.; obtaining of funding: J.P., M.C., C.S., and J.D.T.; and study supervision: M.N.I., A

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Incidental CT Findings in Trauma Patients: Incidence and Implications for Care of the Injured

Cited by 125 publications

References 11 publications

169: Incidental Findings on CT Scans In the Emergency Department

169: Incidental Findings on CT Scans In the Emergency Department

The prevalence and clinical importance of incidental soft-tissue findings in cervical CT scans of trauma population

What’s in a Name? Factors Associated with Documentation and Evaluation of Incidental Pulmonary Nodules

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