Analysis of radiation exposure among pediatric trauma patients at national trauma centers
Related Experiment Video
Updated: May 14, 2026
Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
Published on: May 27, 2022
Anupam B Kharbanda1, Andrew Flood, Karen Blumberg
1Department of Pediatric Emergency Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota 55404, USA. Anupam.kharbanda@childrensmn.org
Insights
Pediatric trauma patients undergoing imaging studies are exposed to significant radiation doses, primarily from computed tomography (CT). Younger children and those with severe injuries receive higher radiation doses, posing potential long-term health risks.
Area of Science:
- Radiology
- Pediatric Trauma Care
- Radiation Oncology
Background:
- Children are uniquely vulnerable to ionizing radiation effects.
- Limited data exists on radiation exposure in pediatric trauma evaluations.
- Assessing radiation dose is crucial for patient safety.
Purpose of the Study:
- To determine the utilization rate of radiologic studies in pediatric trauma patients.
- To estimate the effective radiation dose from these studies.
- To identify factors influencing radiation exposure in this population.
Main Methods:
- Analysis of the National Trauma Data Bank (2010) for pediatric patients (<19 years).
- Inclusion of trauma center patients, excluding transfers and fatalities.
- Examination of computed tomography (CT) and X-ray utilization and effective dose estimation.
Main Results:
- 31.1% of 84,863 pediatric trauma patients received imaging (CT or X-ray).
- Computed tomography (CT) accounted for the majority of radiation exposure (mean 12.0 mSv).
- Younger children and those with higher injury severity received greater radiation doses.
Conclusions:
- Computed tomography (CT) is the primary source of radiation exposure in pediatric trauma.
- Radiation doses increase with younger age and injury severity.
- Potential for long-term harm exists due to radiation exposure in pediatric trauma patients.
Background:
Injured children undergo radiologic studies as part of trauma evaluations. Children are more sensitive than adult patients to the effects of ionizing radiation. Few studies have described the radiation exposure to pediatric patients during trauma evaluations. We sought to describe the rate of use of radiology studies and to estimate the effective dose of radiation delivered to pediatric trauma patients presenting to trauma centers within the United States.
Methods:
We performed an analysis of pediatric patients younger than 19 years who presented to an American College of Surgery-verified trauma center in 2010 (National Trauma Data Bank). We excluded patients who were transferred from another facility, patients who died at the scene or those who presented to the emergency department dead on arrival. We examined the use of computed tomography (CT) and standard radiographs (x-ray). Radiologic studies were identified through common procedure codes (CPT). Using published criteria, we estimated the effective radiation dose per trauma patient.
Results:
Among the 84,863 eligible pediatric trauma patients, 26,360 (31.1%) underwent imaging with x-ray or CT. Of these patients, 17,321 (65.7%) were male, median age was 13.0 years (interquartile range, 6.0-17.0), and 20,965 (79.5%) had an Injury Severity Score (ISS) of less than 16. A total of 23,148 (27.4%) underwent CT. X-ray studies accounted for a small amount of exposure to radiation as compared with CT. Mean (SD) effective radiation exposure of patients imaged with CT was 12.0 (8.2) mSv. Younger children and those with increasing injury severity were exposed to higher doses of radiation (β = -0.04, p < 0.001).
Conclusion:
The majority of radiation exposure to pediatric trauma patients is secondary to CT. Younger children and those with more severe injuries are exposed to higher doses of radiation. Pediatric trauma patients are exposed to levels of radiation, which could potentially lead to long-term harm.
Level Of Evidence:
Epidemiologic study, level III.
