Inpatient radiation exposure in patients with spinal trauma

Area of Science:

• Medical Imaging
• Patient Safety
• Radiology

Background:

• Radiation exposure from medical imaging is a critical patient safety issue.
• Guidelines for patient exposure and cumulative inpatient doses are lacking.
• Spinal imaging contributes significantly to patient radiation dose.

Purpose of the Study:

• To examine cumulative effective radiation dose in hospitalized spinal trauma patients.
• To compare radiation exposure between patients with spinal cord injury (SCI) and spinal fractures.
• To test the hypothesis that SCI patients have higher exposures due to injury severity.

Main Methods:

• Retrospective data analysis of spinal trauma patients admitted to a level I trauma center over two years.
• Determination of Injury Severity Score (ISS) and cumulative effective radiation dose.
• Inclusion of 406 spinal fracture patients and 59 SCI patients.

Main Results:

• SCI patients received a higher cumulative effective dose (45 mSv) than spinal fracture patients (38 mSv).
• Exposure was significantly higher in patients with an ISS over 16.
• Mean exposure in both groups exceeded the European annual occupational limit (20 mSv); over one-third of SCI patients exceeded the US occupational limit (50 mSv).

Conclusions:

• Patients with SCI experienced significantly higher radiation exposure and ISS compared to spinal fracture patients.
• Overall effective doses were high, exceeding occupational safety limits.
• Practitioners should consider cumulative radiation exposure when ordering diagnostic imaging for trauma patients.