Too Many CTs for Trauma Patients Under Standard Protocol

April 16, 2013

Standard CT protocol for trauma patients is leading to overutilization of the exam.

CT use on trauma patients can be reduced by at least half if requests are made based on patient presentation and history rather than standard imaging protocol, according to researchers presenting this week at the American Roentgen Ray Society annual meeting.

Researchers from the University of Pittsburgh Medical Center reviewed the records of 100 patients who were transferred from another facility. "The standard trauma CT protocol for all level 1 and 2 trauma patients transferred to our facility includes a CT examination of the head, cervical spine, thoracic spine, lumbar spine, chest, abdomen and pelvis," lead author Matthew Heller, MD, said in a release.

Results showed that the additional tests generated 463 negative CT examinations. In the seven instances where minor unexpected acute findings were noted, such as non-displaced rib fractures, the course of treatment was not affected.

"In short, scanning patients according to the standard trauma protocol generated hundreds of CT examinations which did not impact the patient's care," Heller said. “On average, we found that the standard trauma protocol generated approximately five CT examinations per patient that were either negative or not clinically significant."

Heller concluded that CT use, as well as cost and radiation dose, could be reduced by at least 50 percent if the standard imaging protocol for trauma patients was replaced by imaging dictated by the patient’s history and physical examination findings.