Research Article| Volume 220, ISSUE 2, P482-488, August 2020

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An evidence-based algorithm decreases computed tomography use in hemodynamically stable pediatric blunt abdominal trauma patients

Published:January 07, 2020DOI:


      • An evidence-based algorithm decreased CT in pediatric blunt abdominal trauma by 27%.
      • Trauma center LOS and hospital admissions did not increase despite less CTs.
      • Pediatric trauma patient radiation exposure decreased without missed injuries.
      • Abstract.



      There are concerns about overuse of abdominopelvic-computed tomography (CTAP) in pediatric blunt abdominal trauma (BAT) given malignancy risks. This study evaluates how an evidence-based algorithm affected CTAP and hospital resource use for hemodynamically stable children with BAT.

      Materials and methods

      This is a retrospective cohort study of hemodynamically stable pediatric BAT patients one year before and after algorithm implementation. We included children less than or equal to 14 years of age treated in a Level I pediatric trauma center. We compared CTAP rates before and after algorithm implementation.


      There were 65 in the pre- and 50 in the post-algorithm implementation group, and CTAPs decreased by 27% (p = 0.02). The unadjusted and adjusted odds ratio of receiving a CTAP after algorithm implementation were 0.3 (95% CI 0.1–0.6) and 0.2 (95% CI 0.1–0.7), respectively. There were no significant missed injuries in the post cohort. ED length of stay (LOS) decreased by 53 min (p = 0.03).


      An evidence-based algorithm safely decreased CTAPs for pediatric BAT with no increase in hospital resource utilization.

      Graphical abstract


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