If a picture is worth a thousand words, what is a trauma computerized tomography panel worth?

Abstract 

Background

There has been a progressive increase in the use of computerized tomography (CT) scans for evaluating trauma patients. The purpose of this study was to quantify that trend and consider the implications it holds for resource use.

Methods

Data were combined from the trauma registry and the radiology department’s administrative information system at a level I trauma center to define the radiographic use patterns applied to all trauma activations during a 3-month sampling period in each of 4 years.

Results

Trauma activations increased by 21% whereas total radiographic studies increased by 82%. The proportion of CT scans to total studies increased progressively from 18% to 27%. The average number of CT studies per patient increased from 2.68 ± 3.09 to 6.88 ± 7.50. CT use increased for patients presenting by primary or secondary transport, regardless of triage classification. In the final sampling period, CT scans alone generated an average of 3,726 images per day to be reviewed.

Conclusions

Increasing use of multi-image studies is facilitated by improvements in technology and medical-legal pressures. However, extensive imaging can stress overburdened trauma systems. Additional studies are needed to assess the implications of increasing radiographic use on trauma outcomes.

Keywords: Trauma (wounds and injuries), Radiography, Tomography, X-ray computed/(utilization), Tomography, Radiograph computed/(adverse effects), Technology assessment, Biomedical