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Screening laboratory and radiology panels for trauma patients have low utility and are not cost effective
James L Tasse1, Mark L Janzen, Naveed A Ahmed
1Division of Trauma and Surgical Critical Care, Department of General Surgery, Huron Hospital, Cleveland Clinic Health System, Cleveland, Ohio, USA. jtasse@cchseast.org
Background:
Routine laboratory and radiology panels as part of the initial evaluation of the trauma patient are prevalent practices. This is a study of utility and cost effectiveness of this practice.
Methods:
During a 3-month period, trauma panels were analyzed for cost and impact on patient care in our institution.
Results:
Four hundred ten consecutive patients had 3,982 studies (cost $417,839) performed of which 1,292 (cost $114,753) were abnormal and only 253 (cost $36,703) were clinically contributory.
Conclusions:
Routine panels are not useful or cost effective. Negative results contribute little to management. Selective and targeted studies should be indicated by the secondary survey, and may result in substantial cost savings ($1,500,000 per year at our institution).
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