Provisional reporting of polytrauma CT by on-call radiology registrars. Is it safe?

To assess the accuracy of provisional reporting and the impact on patient management.

Over a 6 month period, 137 polytrauma computed tomography (CT) examinations were performed by on-call registrar radiologists at our institution. After exclusions, 130 cases were analysed. Discrepancies between registrar and consultant reports were reviewed and classified as either major or minor dependent on potential impact on patient safety. The relationship between seniority of reporting registrar and likelihood of a missed finding was analysed using the Chi-square test.

Of the 130 patients, 46 (35%) had a serious injury, 36 (28%) a minor injury, and 48 (38%) no identifiable injury on CT. There were 32 (25%) patients with discrepancies of which 24 (18%) had missed or significantly under-reported findings and eight (6%) overcalled findings. There were six misses classified as major; the remaining 18 were classified as minor. No association was found between the seniority of reporting registrar and the likelihood of a miss (p=0.96).

The incidence of major discrepancies between the provisional and final report was low and did not lead to any significant clinical deterioration. Our study provides a reference of the commonly missed injuries. We conclude that registrar provisional reporting of polytrauma is safe; however, note that a large proportion of examinations are normal and that further work is required to produce robust criteria given the radiation risk to a young population group scanned in trauma.