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Association of Race and Ethnicity With Computed Tomography Head Utilization in Children Presenting to the Emergency

Nirupama Kannikeswaran1, Lalitha Sivaswamy2, Karin Przyklenk3

  • 1Professor of Pediatrics and Emergency Medicine, Division of Emergency Medicine, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit, Michigan.

Pediatric Neurology
|June 4, 2026
PubMed

Insights

Computed tomography (CT) head scans were common in children with seizures, with age influencing utilization. This study found no significant racial or ethnic disparities in CT head use for pediatric emergency department visits, though findings require cautious interpretation.

Area of Science:

  • Pediatric Emergency Medicine
  • Radiology
  • Health Services Research

Background:

  • Computed tomography (CT) of the head is frequently used in pediatric emergency departments for seizures, despite not being routinely recommended.
  • Existing research suggests potential racial and ethnic disparities in pediatric imaging within emergency departments.
  • This study addresses the need to evaluate demographic factors, including race and ethnicity, in relation to CT head utilization for pediatric unprovoked seizures.

Purpose of the Study:

  • To examine the association between demographic factors, specifically race and ethnicity, and the utilization of CT head imaging in children presenting to the emergency department with unprovoked seizures.
  • To identify any disparities in CT head use based on patient demographics.

Main Methods:

  • A retrospective cross-sectional analysis was performed using data from the National Hospital Ambulatory Medical Care Survey (2016-2022).
  • The study included emergency department visits for patients 18 years or younger with epilepsy or unspecified convulsions as primary reasons for visit.
  • Statistical analyses included complex samples-adjusted Pearson chi-square tests and multivariable logistic regression to assess CT head utilization.

Main Results:

  • The analysis included a weighted sample of 3,936,090 emergency department visits.
  • CT head was performed in 23.6% of visits; utilization was higher in adolescents (38.8%) compared to younger children.
  • No significant association was found between race/ethnicity and CT head utilization in bivariate or multivariate analyses.

Conclusions:

  • CT head imaging is utilized in a significant proportion of pediatric emergency department visits for unprovoked seizures, with age being a key factor in utilization rates.
  • This study did not observe racial or ethnic disparities in CT head utilization among this patient population.
  • The findings regarding race and ethnicity should be interpreted with caution due to statistical reliability limitations in the multivariable estimates.
Abstract

Keywords:
ChildrenNeuroimagingRace and ethnicitySeizures

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