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An assessment of repeat computed tomography utilization in the emergency department in the setting of blunt trauma

An assessment of repeat computed tomography utilization in the emergency department in the... Purpose Computed tomography (CT) is a standard imaging modality utilized during the evaluation of trauma patients in the emergency department (ED). However, while it is common to utilize intravenous (IV) contrast as an adjunct, the use of multiple CT scans and how it impacts patient flow can lead to changes in patient management. Our objectives are to assess length of stay (LOS) and rates of acute kidney injury (AKI), when two CTscans of the abdomen/pelvis are performed compared to one CTscan. Methods Data of trauma hospital encounters were retrospectively collected during a 5-year period at a large, level 1 trauma center. Encounters were categorized into patients who received one or two CT scans of the abdomen/pelvis, as well as if they had received IV contrast or not. CT scan reads were extracted from chart records, and groups were compared. Results Of 5787 patient encounters, 5335 (93.4%) received IV contrast and 75 (1.3%) received two CTscans. Lower rates of AKI were associated with IV contrast (2.5 vs 12.5%). Receiving two CT scans was associated with increased rates of AKI (20.0 vs 3.0%; p < 0.0001), ICU admissions (88.0 vs 25.1%; p < 0.0001), and hospital LOS (21.9 vs 1.4 days; http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Emergency Radiology Springer Journals

An assessment of repeat computed tomography utilization in the emergency department in the setting of blunt trauma

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Publisher
Springer Journals
Copyright
Copyright © 2018 by American Society of Emergency Radiology
Subject
Medicine & Public Health; Imaging / Radiology; Emergency Medicine
ISSN
1070-3004
eISSN
1438-1435
DOI
10.1007/s10140-018-1614-y
Publisher site
See Article on Publisher Site

Abstract

Purpose Computed tomography (CT) is a standard imaging modality utilized during the evaluation of trauma patients in the emergency department (ED). However, while it is common to utilize intravenous (IV) contrast as an adjunct, the use of multiple CT scans and how it impacts patient flow can lead to changes in patient management. Our objectives are to assess length of stay (LOS) and rates of acute kidney injury (AKI), when two CTscans of the abdomen/pelvis are performed compared to one CTscan. Methods Data of trauma hospital encounters were retrospectively collected during a 5-year period at a large, level 1 trauma center. Encounters were categorized into patients who received one or two CT scans of the abdomen/pelvis, as well as if they had received IV contrast or not. CT scan reads were extracted from chart records, and groups were compared. Results Of 5787 patient encounters, 5335 (93.4%) received IV contrast and 75 (1.3%) received two CTscans. Lower rates of AKI were associated with IV contrast (2.5 vs 12.5%). Receiving two CT scans was associated with increased rates of AKI (20.0 vs 3.0%; p < 0.0001), ICU admissions (88.0 vs 25.1%; p < 0.0001), and hospital LOS (21.9 vs 1.4 days;

Journal

Emergency Radiology – Springer Journals

Published: Jun 2, 2018

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