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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Disproportionate Use in Minor Trauma Is Driving Emergency Department Cervical Spine Imaging: An Injury Severity

Akram Khaja1, Michal Horný1, Patricia Balthazar2

  • 1Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.

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Cervical spine imaging in emergency departments increased annually, driven by more CT scans for minor trauma injuries. This trend warrants further investigation into appropriateness and cost-effectiveness.

Keywords:
Cervical spine imagingemergency departmentimaging utilizationinjury severity scoretrauma

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Area of Science:

  • Emergency Medicine
  • Radiology
  • Health Services Research

Background:

  • Clinical practice guidelines aim to reduce unnecessary cervical spine imaging in trauma patients.
  • Previous guideline implementation has shown mixed results in practice.

Purpose of the Study:

  • To assess trends in emergency department (ED) cervical spine imaging utilization among trauma patients.
  • To analyze imaging trends stratified by injury severity.

Main Methods:

  • Utilized IBM MarketScan Commercial Databases (2009-2018) for ED trauma encounters.
  • Classified injury severity (minor, intermediate, major) using ICD codes and ISS algorithm.
  • Employed multivariable Poisson regression to model changes in imaging utilization over time.

Main Results:

  • Overall cervical spine imaging increased 5.7% annually; CT utilization rose 10.5% annually, while radiography decreased 2.7% annually.
  • CT utilization increased most significantly for minor injuries.
  • Radiography use decreased for intermediate and major injuries but remained stable for minor injuries.

Conclusions:

  • Recent increases in cervical spine imaging are primarily due to higher CT use in minor injury cases.
  • Further research is needed to evaluate the appropriateness, cost, and radiation dose implications of these imaging trends.