Related Experiment Video
Updated: Jun 10, 2026
Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure
Published on: July 30, 2009
Neuroimaging for pediatric head trauma: do patient and hospital characteristics influence who gets imaged?
Rebekah Mannix1, Florence T Bourgeois, Sara A Schutzman
1Department of Medicine, Children's Hospital Boston, MA, USA. Rebekah.Mannix@childrens.harvard.edu
Insights
Patient race, age, and hospital type influence neuroimaging use in pediatric head trauma evaluations. Quality improvement efforts targeting general hospitals may reduce unnecessary neuroimaging in children.
Area of Science:
- Pediatric Emergency Medicine
- Radiology
- Health Services Research
Background:
- Head trauma is a common reason for pediatric emergency department visits.
- Neuroimaging is frequently used in evaluating pediatric head injuries, but its utilization varies.
- Identifying factors associated with neuroimaging use is crucial for optimizing care and resource allocation.
Purpose of the Study:
- To identify patient, provider, and hospital characteristics associated with neuroimaging use in children with head trauma.
- To understand disparities in neuroimaging utilization for pediatric head injuries.
Main Methods:
- Cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2002-2006.
- Included children (<=19 years) presenting to US emergency departments with head injuries.
- Multivariable logistic regression analysis was employed to determine factors associated with neuroimaging.
Main Results:
- Of 1,256 pediatric head injury visits, 39% received neuroimaging.
- Factors associated with neuroimaging included white race, older age, general hospital setting, emergent triage, admission/transfer, and attending physician treatment.
- The impact of race on neuroimaging use was less pronounced in pediatric hospitals compared to general hospitals.
Conclusions:
- Patient race, age, and hospital characteristics significantly influence neuroimaging rates in pediatric head trauma.
- Quality improvement initiatives focused on physicians in general hospitals could help standardize and potentially reduce neuroimaging rates.
- Further research may explore the clinical appropriateness and long-term implications of these observed variations.
Objectives:
The objective was to identify patient, provider, and hospital characteristics associated with the use of neuroimaging in the evaluation of head trauma in children.
Methods:
This was a cross-sectional study of children (< or =19 years of age) with head injuries from the National Hospital Ambulatory Medical Care Survey (NHAMCS) collected by the National Center for Health Statistics. NHAMCS collects data on approximately 25,000 visits annually to 600 randomly selected hospital emergency and outpatient departments. This study examined visits to U.S. emergency departments (EDs) between 2002 and 2006. Multivariable logistic regression was used to analyze characteristics associated with neuroimaging in children with head injuries.
Results:
There were 50,835 pediatric visits in the 5-year sample, of which 1,256 (2.5%, 95% confidence interval [CI] = 2.2% to 2.7%) were for head injury. Among these, 39% (95% CI = 34% to 43%) underwent evaluation with neuroimaging. In multivariable analyses, factors associated with neuroimaging included white race (odds ratio [OR] = 1.5, 95% CI = 1.02 to 2.1), older age (OR = 1.3, 95% CI = 1.1 to 1.5), presentation to a general hospital (vs. a pediatric hospital, OR = 2.4, 95% CI = 1.1 to 5.3), more emergent triage status (OR = 1.4, 95% CI = 1.1 to 1.8), admission or transfer (OR = 2.7, 95% CI = 1.4 to 5.3), and treatment by an attending physician (OR = 2.0, 95% CI = 1.1 to 3.7). The effect of race was mitigated at the pediatric hospitals compared to at the general hospitals (p < 0.001).
Conclusions:
In this study, patient race, age, and hospital-specific characteristics were associated with the frequency of neuroimaging in the evaluation of children with closed head injuries. Based on these results, focusing quality improvement initiatives on physicians at general hospitals may be an effective approach to decreasing rates of neuroimaging after pediatric head trauma.
Related Concept Videos
01:14Brain Imaging
These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans), magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), and Transcranial Magnetic Stimulation (TMS).
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...