Selective Computed Tomography (CT) Imaging is Superior to Liberal CT Imaging in the Hemodynamically Normal Pediatric Blunt Trauma Patient
| Autor: | Rachel N. Henry, Kazuhide Matsushima, Reynold Henry, Panagiotis Liasidis, Damon Clark, Aaron Strumwasser, Kenji Inaba, Emily Pott, Adam Golden, Cameron Ghafil |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Population Computed tomography Wounds Nonpenetrating 03 medical and health sciences 0302 clinical medicine Blunt Medicine Humans education Child Retrospective Studies education.field_of_study medicine.diagnostic_test business.industry Trauma center Infant Radiation Exposure medicine.disease Los Angeles Blunt trauma 030220 oncology & carcinogenesis Child Preschool Cohort 030211 gastroenterology & hepatology Surgery Female Radiology Ct imaging business Tomography X-Ray Computed Pediatric trauma |
| Zdroj: | The Journal of surgical research. 266 |
| ISSN: | 1095-8673 |
| Popis: | The optimal imaging strategy in hemodynamically stable pediatric blunt trauma remains to be defined. The purpose of this study was to determine the differences between selective and liberal computed tomography (CT) strategy in a pediatric trauma population with respect to radiation exposure and outcomes.We performed a retrospective analysis of hemodynamically stable blunt pediatric trauma patients (≤16 y) who were admitted to a Level I trauma center between 2013-2016. Patients were stratified into selective and liberal imaging cohorts. Univariate and multivariate regression analyses were used to compare outcomes between the groups. Outcomes included radiation dose, hospital and ICU length of stay, complications and mortality.Of the 485 patients included, 176 underwent liberal and 309 selective CT imaging. The liberal cohort were more likely to be severely injured (ISS15: 34.1 versus 8.4%, P0.001). The odds of exposure to a radiation dose of15 mSv were higher with liberal scanning in patients with both ISS15 (OR 2.78, 95% CI 1.76-5.19, P0.001) and ISS ≤ 15 (OR 3.41, 95% CI 2.19-8.44, P0.001). Adjusted outcomes regarding mortality, ICU length of stay, and complications were similar between the cohorts.Selective CT imaging in hemodynamically stable blunt pediatric trauma patients was associated with reduced radiation exposure and similar outcomes when compared to a liberal CT strategy. |
| Databáze: | OpenAIRE |
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