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Is computerized tomography of trauma patients associated with a transfer delay to a regional trauma centre?
Justin Onzuka1, Andrew Worster, Bill McCreadie
1Division of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada.
Objective:
Many trauma patients undergo advanced diagnostic imaging before being transferred to a regional trauma centre, but this step can delay definitive care. This study compared the length-of-stay at the primary hospital between patients who underwent CT scans and those who did not.
Methods:
This was a medical record review of all consecutive trauma cases transferred to a regional trauma centre servicing 2.2 million people during a 2-year period. Two trained abstractors, blind to each other's results, collected data independently.
Results:
Of 249 cases, 79 (31%) underwent a CT scan before being transferred. There was no significant difference in the Injury Severity Score between the 2 groups (p = 0.16), yet the CT group remained at the primary hospital approximately 90 minutes longer before transfer (p < 0.001).
Conclusion:
A significant proportion of trauma patients transferred to a regional trauma centre undergo CT scanning at the primary hospital. These patients experience an increased length-of-stay of 90 minutes, on average, before transfer. This appears to be a common practice that does not appear to contribute to definitive trauma management.
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