The use of CT exams in pediatric trauma patients has declined or stayed the same for most clinical applications over the past decade, according to an analysis published online February 25 in Radiology.
The researchers analyzed 15 years of CT exams ordered for 64,425 patients younger than 55 who had been admitted to Harborview Medical Center, a level I trauma center in Seattle, from 1996 to 2010. The team had anecdotally noticed a reduction in CT exams for trauma patients, particularly for children who were admitted, and wanted to confirm this.
Records of 9,047 patients ages 14 or younger, 5,574 patients ages 15 to 18, and 49,804 patients ages 19 to 54 (for comparison) were retrospectively evaluated. A minority of patients had multiple CT scans performed.
From 2008 to 2010, usage rates in children up to 18 years of age were relatively unchanged or slightly decreased for almost all CT exams. For children younger than 15, the usage rate for head CT exams peaked in 2004, after which decreases were consistently recorded through 2010.
Both abdominal and pelvic CT for patients younger than 15 peaked in 2005 and decreased gradually until 2010. However, the usage rate in 2010 was higher than in 2000. The rate of spine and thoracic CT use was higher between 2004 and 2010 as compared to 2000, but it remained relatively stable over the past five years.
The scope of the analysis did not include patients who were just admitted to the emergency department, according to lead author Dr. Bahman Roudsari, PhD, and colleagues. It also did not include an evaluation of the appropriateness of the imaging exams that were performed.
