Back to Search
Start Over
Disparities in Radiation Burden from Trauma Evaluation at Pediatric Versus Nonpediatric Institutions
- Source :
- The Journal of surgical research. 232
- Publication Year :
- 2017
-
Abstract
- Computed tomography (CT) imaging protocols and prescribing practices vary across institutions. Pediatric trauma patients imaged at a pediatric trauma center (PTC) may receive less radiation than patients imaged at non-PTCs before transfer. Our objective was to determine differences in radiation exposure from imaging performed at a PTC versus non-PTCs.This retrospective analysis included patients18 y old who underwent CT imaging from January 2013 to August 2015 during a trauma-related encounter. Radiation doses from CT scans were estimated and compared between scans performed at our PTC and non-PTCs before patient transfer using propensity score-weighted median regression.Of 3530 CT scans, 3021 were performed at our PTC and 509 at non-PTCs. Patients imaged at non-PTCs were older and had higher injury severity (all P 0.05). Patients imaged at non-PTCs more frequently had neck CT (29.0% versus 7.3%) and chest CT (8.3% versus 2.7%), less frequently had abdomen/pelvis CT (19.5% versus 27.9%, all P 0.01), and had similar rates of head CT (83.9% versus 80.9%, P = 0.18). After propensity weighting, CT scanning was more frequent at non-PTCs and patients received higher cumulative radiation exposure overall (median effective dose 2.36 versus 1.57 mSv, P 0.001) and for each body region imaged (17% more for head, 191% for neck, 81% for chest, and 33% for abdomen/pelvis).Pediatric trauma patients imaged at a PTC receive lower radiation burden from CT imaging than patients initially imaged at adult institutions. Broader adoption of pediatric dosing protocols or deferring noncritical CT scans until transfer may mitigate these disparities.
- Subjects :
- Male
medicine.medical_specialty
endocrine system diseases
Adolescent
Computed tomography
Radiation Dosage
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Trauma Centers
Retrospective analysis
medicine
Humans
Dosing
Child
Propensity Score
Retrospective Studies
medicine.diagnostic_test
business.industry
Infant
030208 emergency & critical care medicine
Radiation Exposure
medicine.disease
humanities
Radiation exposure
Child, Preschool
Wounds and Injuries
Surgery
Female
Radiology
Ct imaging
business
Tomography, X-Ray Computed
Pediatric trauma
Subjects
Details
- ISSN :
- 10958673
- Volume :
- 232
- Database :
- OpenAIRE
- Journal :
- The Journal of surgical research
- Accession number :
- edsair.doi.dedup.....bcc3486504575c7293b83ac9be2134ad