Understanding abdominal pelvic computerized tomography scan usage amongst adolescent blunt trauma patients treated at adult trauma centers |
| |
| Affiliation: | 1. Morehouse School of Medicine, Department of Surgery, 720 Westview Drive, Atlanta, GA 30310, United States;2. Mercer University School of Medicine, Department of Community Medicine, 1501 Mercer University Drive, Macon, GA 30341, United States;3. Emory University School of Medicine, Department of Surgery, 69 Jesse Hill Jr. Dr. SE, Atlanta, GA 30303, United States;1. IPGME&R-SSKM Hospital, Kolkata, India;2. Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Sweden;3. Department of Neurosurgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal;4. Addl Professor Critical and Intensive Care, JPN Apex Trauma Hospital, AIIMS, New Delhi, India;5. WHO Collaborating Centre for Research in Surgical Care Delivery in LMIC, Mumbai, India;6. Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden;7. Injury Division, The George Institute, New Delhi, India;1. Department of Surgery, Brigham and Women''s Hospital, Boston, MA, USA.;2. Department of Surgery, University of Chicago, Chicago, IL, USA.;3. Division of Trauma and Critical Care Surgery, Department of Surgery, Brown University, Providence, RI, USA.;1. Cohen Children''s Medical Center at Northwell Health, Zucker-Hofstra School of Medicine, United States;2. Garnet Health Medical Center, Touro College of Osteopathic Medicine, Middletown, NY;1. School of Public Health and Preventive Medicine, Monash University, Victoria, Australia;2. Emergency & Trauma Centre, The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia;3. National Trauma Research Institute, The Alfred Hospital, Victoria, Australia;4. Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia;5. School of Psychological Sciences, Monash University, Victoria, Australia;6. Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Victoria, Australia;1. Vanderbilt University School of Medicine, Nashville, TN, United States;2. Department of Neurological Surgery, Vanderbilt University Medical Center, Section of Surgical Sciences, Nashville, TN United States;3. Division of Acute Care Surgery, Department of Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN United States;4. Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, United States;5. Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States;6. Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, United States;7. Surgical Services, Geriatric Research Education and Clinical Centers, Tennessee Valley Healthcare System, United States Department of Veterans Affairs, Nashville, TN, United States;8. Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt Brain Institute, United States |
| |
| Abstract: | ![]()
IntroductionThe algorithm for evaluating adolescent patients with blunt trauma includes abdominal pelvic CT (APCT). The aim of this study is to evaluate the utility of APCT in this context.MethodsWe performed a retrospective review of adolescent (11 to 18 years of age) blunt trauma patients at an urban adult level 1 trauma center from January 2015 to December 2019. The primary outcome was the prevalence of positive findings on APCT scan. Additionally, clinical risk factors concerning for intra-abdominal injury were analyzed.ResultsThere were 546 patients evaluated for blunt trauma and the prevalence of APCT within the population was 59.3% (95% CI 54.2%-64.9%). Of the patients who received APCT, 123 (37.9%) had positive findings on APCT. Only 25 patients (7.7% of those who underwent APCT) required abdominal surgery while 40 patients (12.3%) had intraabdominal injury that did not require surgery. Risk factors were present in 100% of patients with intraabdominal injury and absent in 28.7% of patients without intraabdominal injury. Abnormal abdominal exam, abnormal FAST, positive chest x-ray and elevated transaminases were independently associated with intraabdominal injury.ConclusionsOur study found that adolescent blunt trauma patients treated at our trauma center had a higher rate of APCT usage, but a comparable rate of positive findings when compared with the most recent literature. Future studies should focus on reducing the number of patients who undergo APCT despite an absence of clinical risk factors. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
