Bahman Sayyar Roudsari MD, PhD, Presenter: Nothing to Disclose

Kevin Psoter, Abstract Co-Author: Nothing to Disclose

Jeffrey Gil Jarvik MD, MPH, Abstract Co-Author: Consultant, HealthHelp Stockholder, PhysioSonics, Inc Founder, PhysioSonics, Inc Patent Holder, PhysioSonics, Inc Royalties, PhysioSonics, Inc Founder, Nevro Imaging, Inc Stockholder, Nevro Imaging, Inc Advisory Board, General Electric Company

To evaluate the burden of alcohol related injuries on the radiology services at a level I trauma center

We linked the trauma registry (2005-2009) of Harborview Medical Center (HMC) to the billing deartment data. The billing data included detailed information in regards to all resources that had been utilized for the patients during hospitalization. The primary exposure of interest was blood alcohol concentration (BAC) obtained from the trauma registry. The main outcome of interest was the number of CTs per body region (cervical spine, head, maxillofacial, abdominal, thoracic pelvis, extremities). Negative binomial analysis was used to evaluate whether utilization of CT  was associated with BAC level, after adjustment for age, gender, insurance status, mechanism and severity of injury and disposition status.

A total of 125,776 CTs were performed for 27,274 patients during the study period. Overall, higher BAC level was associated with higher utilization of all types of CTs even after adjustment for the potential confounders. Cervical spine, head and maxillofacial CTs demonstrated the most prominent difference in utilization  between alcohol and non-alcohol-related injuries. Utilization of head CT for patients with BAC≥ 240 mg/dl was 1.43 (95% CI: 1.32-1.54) compared to patients with BAC=0. All categories of BAC>0, relative to BAC=0 demonstrated significantly higher utilization of maxillofacial CT; however, no dose-response relationship was observed. Higher BAC level was associated with higher utilization of abdominal CT; although patients with BAC=1-79 had slightly lower utilization rate (IRR: 0.88, 95% CI: 0.80-0.97), patients with BAC of 160 to 239 (IRR: 1.19, 95% CI: 1.10-1.29) and 240+ (IRR:1.38, 95% CI:1.26-1.50) had higher utilization rates compared to the patients with BAC=0.

Alcohol-related injuries are significantly associated with the higher use of imaging technology. In addition, for many types of CTs, such as head and neck CT, there is a dose-response relationship between BAC level and CT use. Unfortunately, there is no study that has investigated the association between higher utilization of CT and better outcome for trauma patients.

In order to optimize the use of imaging technology in level I trama centers, researchers should develop robust protocols that minimize over-utilization of these services for alcohol-related injuries.

Sayyar Roudsari, B, Psoter, K, Jarvik, J, Burden of Alcohol-related Injuries on Radiology Services at Level 1 Trauma Centers.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11014060.html