An evidence-based algorithm decreases computed tomography use in hemodynamically stable pediatric blunt abdominal trauma patients - 20/06/20
, Brian Yorkgitis b , Lori Gurien b , Phyllis Hendry a , Marie Crandall b , David Skarupa b , Jennifer N. Fishe a, ⁎ 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.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
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. |
Keywords : Blunt abdominal trauma, Computed tomography, Pediatrics
Plan
| ☆ | 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. |
Vol 220 - N° 2
P. 482-488 - août 2020 Retour au numéro
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