The Utility of Computed Tomography as a Screening Tool for the Evaluation of Pediatric Blunt Chest Trauma

Markel, Troy A.; Kumar, Rajiv; Koontz, Nicholas A.; Scherer, L.R.; Applegate, Kimberly E.

doi:10.1097/ta.0b013e318184ba9a

Cited by 42 publications

(25 citation statements)

References 21 publications

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“…The utility and importance of CT in trauma patients cannot be understated (2,28,29). However, optimal use of these resources is the ultimate goal of all ongoing campaigns, guidelines, and protocols.…”

Section: Health Policy and Practice: Ct Use For Hospitalized Pediatrimentioning

confidence: 99%

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

et al. 2013

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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

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Section: Health Policy and Practice: Ct Use For Hospitalized Pediatrimentioning

confidence: 99%

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

et al. 2013

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“…Indeed, many clinical practice guidelines, particularly in the emergent setting, have supplanted conventional radiography with CT and MRI examinations as the key elements in their clinical decision-making algorithm (4). Much of this evolution has been driven by evidence-based medicine of the superiority of cross-sectional imaging over conventional radiography in the accurate detection of disease (4,(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Advances in multidetector CT, dual-source CT, gradientbased MR pulse sequences, and novel pulse sequences have also greatly diminished the acquisition time of these studies, permitting a higher-throughput model of health care delivery (2,3,5,20-22).…”

mentioning

confidence: 99%

The Effects of Changes in Utilization and Technological Advancements of Cross-Sectional Imaging on Radiologist Workload

McDonald¹,

Schwartz²,

Eckel³

et al. 2015

Academic Radiology

302

155

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“…There is also a growing concern regarding the possible collateral effects of indiscriminate use of CT due to exposure to radiation, especially in the pediatric population. [15][16][17][18] Thus, better ways of selecting patients to be submitted to complementary examinations are being sought.…”

Section: Resultsmentioning

confidence: 99%

Fundamentos Para La Elaboración De Manuscritos Científicos En Trauma Y Cuidado Agudo De Emergencias (Parte 3): Como Seleccionar La Mejor Opción Para Publicar Su Trabajo: Más Allá Del Factor De Impacto

Echeverri¹,

Montenegro²,

Oviedo³

et al. 2017

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Background:There is an excessive number of unnecessary chest X-rays (CXRs) in minor blunt trauma patients.Objective: To identify, using routine clinical criteria, a subgroup of blunt trauma patients that do not require CXR for assessment. Materials and methods:This was a retrospective analysis of trauma registry data collected over a 24-month period. Adult blunt trauma patients undergoing CXR on admission were analyzed. The following clinical criteria were assessed: Normal neurologic examination on admission (NNEx), hemodynamic stability (HS), normal physical examination of the chest on admission (NCEx), age ≤ 60 years, and absence of distracting injuries (Abbreviated Injury Scale >2 in head, abdomen, and extremities). These clinical criteria were progressively merged to select a group with lowest risk of exhibiting abnormal CXR on admission.Results: Out of 4,647 patients submitted to CXR on admission, 268 (5.7%) had abnormal findings on scans. Of 2,897 patients admitted with NNEx, 116 (4.0%) had abnormal CXR. Of 2,426 patients with NNEx and HS, 74 (3.0%) had abnormal CXR. Of 1,698 patients with NNEx, HS, and NCEx, 24 (1.4%) had abnormal CXR. Of 1,347 patients with NNEx, HS, NCEx, and age < 60 years, 12 had thoracic injury (0.9% of total individuals receiving CXR). A total of 4 patients underwent chest drainage. Among 1,140 cases with all clinical criteria, 8 had confirmed thoracic injuries and 2 underwent chest drainage. Conclusion:A subgroup of blunt trauma patients with low probability of exhibiting abnormalities on CXR at admission was identified. The need for CXR in this subgroup should be reviewed.

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The Utility of Computed Tomography as a Screening Tool for the Evaluation of Pediatric Blunt Chest Trauma

Cited by 42 publications

References 21 publications

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

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

The Effects of Changes in Utilization and Technological Advancements of Cross-Sectional Imaging on Radiologist Workload

Fundamentos Para La Elaboración De Manuscritos Científicos En Trauma Y Cuidado Agudo De Emergencias (Parte 3): Como Seleccionar La Mejor Opción Para Publicar Su Trabajo: Más Allá Del Factor De Impacto

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