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Radiation exposure has increased in trauma patients over time
Kasra Ahmadinia1, J Benjamin Smucker, Clyde L Nash
1Department of Orthopaedic Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109, USA.
The Journal of Trauma and Acute Care Surgery
|February 14, 2012
Summary
Radiation exposure and costs from computed tomography (CT) scans in trauma patients significantly increased between 2002 and 2008. This rise in CT utilization occurred without changes in patient outcomes or injury severity, highlighting potential areas for optimization.
Area of Science:
- Radiology
- Medical Imaging
- Trauma Care
Background:
- Computed tomography (CT) is a primary imaging tool in trauma centers.
- Trends in radiation exposure and associated costs require evaluation.
Purpose of the Study:
- To assess changes in radiation exposure and diagnostic imaging charges for trauma patients over time.
- To test the hypothesis that radiation dosage and charges increase without changes in patient acuity or outcomes.
Main Methods:
- Retrospective review of 500 consecutive trauma patients from 2002, 2005, and 2008.
- Quantification of CT scans, plain radiographs, total radiation dose (mSv), and imaging charges.
- Determination of injury severity scores and mortality rates.
Main Results:
- CT scan utilization per patient more than doubled between 2002 and 2008.
- Total radiation exposure increased significantly, with mean doses rising from 12.0 to 33.6 mSv (Category 1) and 17.5 to 37.5 mSv (Category 2).
- Diagnostic imaging charges per patient also increased substantially, with Category 1 rising from $2,933 to $6,677 and Category 2 from $4,105 to $7,365.
Conclusions:
- Increased CT use in trauma care leads to higher radiation exposure and costs.
- No concurrent improvement in patient mortality or injury severity was observed.
- Judicious application of advanced imaging may mitigate risks and control costs without compromising patient care.
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