Trauma surgeon utilization of computerized tomography scanning: Room for improvement?

Area of Science:

• Traumatology
• Radiology
• Medical Imaging

Background:

• Trauma team activations (TTA) involve critical decision-making regarding diagnostic imaging.
• Computerized tomography (CT) is a key imaging modality in trauma care.
• Evaluating CT utilization and diagnostic yield is crucial for optimizing patient care.

Purpose of the Study:

• To assess the utilization rates of various CT scans during trauma team activations.
• To determine the diagnostic yield of CT scans in identifying significant findings.
• To compare CT utilization and yield between different TTA levels (trauma alert vs. trauma response).

Main Methods:

• Retrospective review of 647 trauma team activations over nine months.
• Categorization of TTAs into trauma alert (TAL) and trauma response (TR) levels.
• Recording of CT utilization and significant finding (SF) yields for brain, cervical, chest, and abdomen/pelvis CTs.

Main Results:

• No significant difference in overall CT utilization between TAL and TR, except for brain CTs (98% vs. 94%).
• Cervical spine CTs showed a higher yield in TAL (8%) compared to TR (4%).
• Over 80% of patients received a pan-scan; 63% of all CTs yielded no significant findings.

Conclusions:

• CT scans appear to be overutilized in trauma team activations, irrespective of activation level.
• A substantial proportion of CT scans in trauma patients do not reveal significant findings.
• Selective use of CT imaging in trauma care warrants further evaluation to improve efficiency and resource allocation.