Understanding Chest CT Scan Usage Among Adolescent Blunt Trauma Patients at Adult Trauma Centers

Area of Science:

• Emergency Medicine
• Radiology
• Trauma Surgery

Background:

• The diagnostic utility of chest computed tomography (CCT) in adolescent blunt trauma patients remains unclear.
• Establishing optimal diagnostic algorithms is crucial for effective trauma care.

Purpose of the Study:

• To evaluate the role and necessity of CCT in the initial assessment of adolescent patients experiencing blunt force trauma.
• To determine if CCT provides critical information beyond standard clinical evaluation and radiography.

Main Methods:

• A retrospective review of adolescent blunt trauma patients treated at an urban level 1 adult trauma center (2015-2019).
• Analysis of CCT findings, patient demographics, injury severity scores (ISS), Glasgow Coma Scale (GCS), and chest X-ray (CXR) results.
• Univariate and multivariate logistic regression analyses were employed to identify predictors of positive CCT findings.

Main Results:

• Of 288 patients, 153 had positive CCT findings. Positive CCT was associated with higher ISS, lower GCS, positive CXR, chest pain, and abnormal chest exam findings.
• Positive CXR and ISS were independently associated with positive CCT findings on multivariate analysis (OR = 13.96 and 3.10, respectively).

Conclusions:

• Clinical examination combined with chest X-ray (CXR) may be sufficient for diagnosing chest trauma in adolescent blunt trauma patients.
• Reducing reliance on CCT can potentially minimize radiation exposure without compromising patient care in adult trauma centers.