Highlights
- •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.
Abstract
Background
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.
Results
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).
Conclusions
An evidence-based algorithm safely decreased CTAPs for pediatric BAT with no increase
in hospital resource utilization.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: January 07, 2020
Accepted:
January 3,
2020
Received in revised form:
January 2,
2020
Received:
June 13,
2019
Footnotes
☆This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
☆☆Academic Emergency Medicine, February 2019. Academic Emergency Medicine, Poster Presentation at the Society for Academic Emergency Medicine Regional Meeting. February 2019, (Greenville, SC).
☆☆☆Academic Emergency Medicine, May 2019. Academic Emergency Medicine, Oral Presentation at Society for Academic Emergency Medicine National Conference. May 2019, Las Vegas, NV.
Identification
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