Trauma: the impact of repeat imaging

• Published in: The American journal of surgery Vol. 198; no. 6; pp. 858 - 862
• Main Authors: Haley, Theodore, M.D, Ghaemmaghami, Vafa, M.D, Loftus, Terrence, M.D, Gerkin, Richard D., M.D, Sterrett, Robert, M.D, Ferrara, John J., M.D
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.12.2009; Elsevier; Elsevier Limited
• Subjects: Adult; Biological and medical sciences; Diagnostic systems; Emergency services; Fees & charges; General aspects; Hospitals; Humans; Imaging; Injuries; Injury analysis; Medical imaging; Medical referrals; Medical sciences; Morbidity; Patient Transfer - statistics & numerical data; Patients; Prospective Studies; Radiology; Regression analysis; Repeat imaging; Studies; Surgeons; Surgery; Tomography; Tomography, X-Ray Computed - statistics & numerical data; Trauma; Trauma centers; Trauma radiology; Trauma transfer; Variables; Wounds and Injuries - diagnostic imaging; Trauma transfer; Repeat imaging; Trauma radiology; Medicine; Treatment; Surgery; Radiology; Transfer; Medical imagery; Trauma
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2009.05.030

Abstract Background Patients referred to trauma centers often undergo an extensive diagnostic work-up before transfer. The purpose of our study was to quantify and examine the effects of repeat imaging in this population. Methods A prospective cohort study of 410 patient transfers was performed. Repeat imaging was conducted at the discretion of the accepting surgeon for multiple reasons. Two groups were compared, those who did and those who did not require repeat imaging. Results Overall, 53% of referrals received repeat imaging, at an average cost of $2,985 per patient. This group was older (42 vs 37 y; P < .05), more severely injured (injury severity score, 12 vs 9; P < .05), and experienced longer delays before transfer (244 vs 192 min; P < .05). By using logistic regression analysis, injury severity score was found to be an independent predictor of the need for repeat imaging ( P = .003). Conclusions Severely injured trauma patients often receive films that ultimately require duplication, resulting in transfer delay, unnecessary morbidity, and increased resource use. Targeted education and development of centralized radiology systems could alleviate some of the burden of unnecessary imaging.