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

Daniel Shawn Moore MD, Abstract Co-Author: Nothing to Disclose

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

Janessa Graves, Abstract Co-Author: Nothing to Disclose

To evaluate the 11 years (1996-2006) trend in utilization of repetitive (≥2) CTs for patients admitted to an adult level I trauma center because of motor vehicle collisions .

We linked trauma registry to billing department data and used ICD-9 procedure codes to identify the type and frequency of the performed CTs for each patient. Patients ≥13 years were eligible to be admitted to our level I trauma center. We used negative binomial analysis to evaluate the association between the frequency of CTs and the following variables: age, year of admission, gender, ethnicity, insurance status, injury severity score, ICU admission status and patient disposition at the time of discharge. Logistic regression was used to evaluate the association between repetitive (≥2) head, thorax, abdomen and other body regions (including spine and extremities) CTs and previously mentioned covariates.  

On average, utilization rate of head, abdomen, thorax and other body region (including spine and extremities) CTs increased 4%, 13%, 13% and 17% per year, respectively. Relative to adults 19-55 years, adolescents 13-18 years had higher chance for receiving head CT (IRR: 1.16, 95% CI: 1.10-1.22) and lower chance for being evaluated by thoracic CT (IRR: 0.55, 95% CI: 0.47-0.63). Repetitive (≥2) use of CT on average increased 12% /year for head and abdomen CTs, 18%/year for thorax CTs and  40%/year for other types of CTs (95% CI: 38-43%). Adolescents had 53% higher odds of receiving ≥2 head CTs (OR: 1.53, 95% CI: 1.31-1.80) and 64% lower odds for receiving ≥2 thoracic CTs (OR: 0.36, 95% CI: 0.21-0.62), relative to adults 19-55 years. The odds of receiving repetitive head, abdomen, thorax and other body region CTs in 2006, relative to 2000 was 1.27 (95% CI: 0.98-1.64), 1.75 (95% CI: 1.1-2.8), 1.63 (95% CI: 0.92-2.88) and 7.1 (95% CI: 5.8-8.6), respectively.  

Utilization of different body region CTs for MVC victims admitted to our level I trauma center has increased substantially during the past several years. This increase was more prominent for repetitive use of  “other body regions ” CTs.

Future studies should evaluate the appropriateness of the performed CTs and also the potential influence of the current escalating utilization rate on patients’ outcome and cost of care.

Roudsari, B, Moore, D, Jarvik, J, Graves, J, Eleven Years Trend in Utilization of Repetitive Computed Tomography (CT) for Victims of Motor Vehicle Collisions Admitted to a Level I Trauma Center.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9006260.html