Prior CT imaging history for patients who undergo whole-body CT for acute traumatic injury and are discharged home from the emergency department

Autor: Scott Krall, Albert L Gest, K Tom Xu, Osbert Blow, Peter Richman, Kimberly Leeson, Mary Matthews
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Adult
Male
medicine.medical_specialty
lcsh:Special situations and conditions
Whole body ct
Malignancy
03 medical and health sciences
0302 clinical medicine
Injury Severity Score
medicine
Acute traumatic injury
Humans
030212 general & internal medicine
Pelvis
Retrospective Studies
business.industry
lcsh:RC952-1245
lcsh:Medical emergencies. Critical care. Intensive care. First aid
Accidents
Traffic
030208 emergency & critical care medicine
Retrospective cohort study
lcsh:RC86-88.9
Emergency department
Middle Aged
medicine.disease
Patient Discharge
Discharge from ED
Traumatic injury
medicine.anatomical_structure
Logistic Models
Radiological weapon
Emergency Medicine
Wounds and Injuries
CT scans
Female
Radiology
Ct imaging
business
Emergency Service
Hospital
Tomography
X-Ray Computed
Research Article
Zdroj: BMC Emergency Medicine
BMC Emergency Medicine, Vol 18, Iss 1, Pp 1-5 (2018)
ISSN: 1471-227X
Popis: Background Recurrent CT imaging is believed to significantly increase lifetime malignancy risk. We previously reported that high acuity, admitted trauma patients who received a whole-body CT in the emergency department (ED) had a history of prior CT imaging in 14% of cases. The primary objective of this study was to determine the CT imaging history for trauma patients who received a whole-body CT but were ultimately deemed safe for discharge directly home from the ED. Methods This was a retrospective cohort study conducted at an academic ED. All trauma patients who were discharged directly home from the ED after whole-body CT were analyzed. The decision to utilize whole-body CT was at the discretion of the caring physician during the study period. Clinical data for the most recent trauma visit was recorded in a structured fashion on a standardized data collection instrument utilizing the hospital system electronic medical record (EMR). Subsequently, study investigators reviewed a shared, electronic radiological archive for the 6-hospital system to evaluate prior CT exposure for each patient. Results 165 patients were in the study group. The mean age of the study group was 39+/− 16 years old, 40% were female and 64% were Hispanic. The most common mechanism of injury in our study group was motor vehicle crash (MVC) (66%). In our study group, 25% had at least one prior CT. The most common prior studies performed were: CT abdomen/pelvis (13%), CT head (9.1%), CT face (6.7%), and CT chest (1.8%). Within a multivariate logistic regression model we found that the large majority of patient characteristics and mechanisms of injury were not associated with a positive prior CT imaging history. Conclusion We found a positive history for prior CT for 25% of trauma patients who received whole-body CT scan but were discharged from the ED to home.
Databáze: OpenAIRE
Externí odkaz: