Declining trend in the use of repeat computed tomography for trauma patients admitted to a level I trauma center for traffic-related injuries
| Autor: | Bahman Sayyar Roudsari, Jeffrey G. Jarvik, Janessa M. Graves, Christopher D. Mack, Kevin J. Psoter |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Washington medicine.medical_specialty Adolescent Poison control Logistic regression Article law.invention Young Adult Age Distribution Trauma Centers Risk Factors law Internal medicine Injury prevention Prevalence medicine Humans Radiology Nuclear Medicine and imaging Registries Sex Distribution Young adult Pelvis Aged Aged 80 and over Trauma Severity Indices business.industry Trauma center Accidents Traffic Infant Newborn Infant General Medicine Middle Aged Intensive care unit Surgery medicine.anatomical_structure Child Preschool Utilization Review Wounds and Injuries Female Body region Tomography X-Ray Computed business |
| Zdroj: | European Journal of Radiology. 82:969-973 |
| ISSN: | 0720-048X |
| DOI: | 10.1016/j.ejrad.2012.12.007 |
| Popis: | Objective To evaluate the trend in utilization of repeat (i.e. ≥2) computed tomography (CT) and to compare utilization patterns across body regions for trauma patients admitted to a level I trauma center for traffic-related injuries (TRI). Materials and Methods We linked the Harborview Medical Center trauma registry (1996–2010) to the billing department data. We extracted the following variables: type and frequency of CTs performed, age, gender, race/ethnicity, insurance status, injury mechanism and severity, length of hospitalization, intensive care unit (ICU) admission and final disposition. TRIs were defined as motor vehicle collisions, motorcycle, bicycle and pedestrian-related injuries. Logistic regression was used to evaluate the association between utilization of different body region repeat (i.e. ≥2) CTs and year of admission, adjusting for patient and injury-related characteristics that could influence utilization patterns. Results A total of 28,431 patients were admitted for TRIs over the study period and 9499 (33%) received repeat CTs. From 1996 to 2010, the proportion of patients receiving repeat CTs decreased by 33%. Relative to 2000 and adjusting for other covariates, patients with TRIs admitted in 2010 had significantly lower odds of undergoing repeat head (OR = 0.61; 95% CI: 0.49–0.76), pelvis (OR = 0.37; 95% CI: 0.27–0.52), cervical spine (OR = 0.23; 95% CI: 0.12–0.43), and maxillofacial CTs (OR = 0.24; 95% CI: 0.10–0.57). However, they had higher odds of receiving repeat thoracic CTs (OR = 1.86; 95% CI: 1.02–3.38). Conclusion A significant decrease in the utilization of repeat CTs was observed in trauma patients presenting with traffic-related injuries over a 15-year period. |
| Databáze: | OpenAIRE |
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