Arthur Baghdanian MD, Presenter: Nothing to Disclose

Christina Alexandra Lebedis MD, Abstract Co-Author: Nothing to Disclose

Armonde Baghdanian MD, Abstract Co-Author: Nothing to Disclose

Anthony Samuel Armetta MD, Abstract Co-Author: Nothing to Disclose

Stephan W. Anderson MD, Abstract Co-Author: Nothing to Disclose

Jorge A. Soto MD, Abstract Co-Author: Nothing to Disclose

Milo Krastev, Abstract Co-Author: Nothing to Disclose

Peter A. Burke MD, Abstract Co-Author: Nothing to Disclose

Tracey Dechert MD, Abstract Co-Author: Nothing to Disclose

To evaluate how the implementation of an institutional triaging algorithm impacted the utilization of MDCT imaging of the abdomen and pelvis at a level one trauma center.

This retrospective HIPAA compliant study was IRB approved. Informed consent was waived. All adult patients admitted for abdominal trauma from 1/1/06-12/31/13 were included in this study. The total number of abdomino-pelvic CT scans acquired, mean injury severity score (ISS) and percentage of trauma scans with positive findings per year were recorded. We then determined the impact that a triaging clinical algorithm, introduced in January 2009, had on these parameters. Patients were divided into two groups: before the implementation of this triaging algorithm (2006-2009) and after (2010-2013). The unpaired t-test and Fisher's exact test were used to compare the two groups for significant differences in the ISS and percentage of positive CT scans, respectively.

The number of annual trauma admissions and the percentage of these patients who received abdomino-pelvic CT scans were: 2006 (2122/71%), 2007 (2234/74%), 2008 (2231/71%), 2009 (2033/60%), 2010 (2167/44%), 2011 (1929/43%), 2012 (1923/36%), and 2013 (1729/39%). The mean ISS and percentage of positive scans for the same time period were: 2006 (9/18%), 2007 (9/19%), 2008 (8/19%), 2009 (9/17%), 2010 (10/20%), 2011 (10/24%), 2012 (11/22%) and 2013(9/20%). Patients admitted after the implementation of the clinical trauma algorithms had a significantly higher mean ISS and a significantly higher percentage of positive CT scans (p<0.0001; p<0.0002, respectively).

The implementation of a clinical algorithm at our level one trauma center resulted in decreased utilization of trauma CT scanning. Our analysis suggests that this clinical algorithm can be used successfully to select patients who require CT imaging in the trauma setting.

In the trauma setting, institutional algorithms can be implemented to prevent unnecessary imaging of patients in a nationwide effort to reduce radiation exposure and hospital costs.

Baghdanian, A, Lebedis, C, Baghdanian, A, Armetta, A, Anderson, S, Soto, J, Krastev, M, Burke, P, Dechert, T, Trauma Imaging: An Institutional Triaging Algorithm and Its Impact on MDCT Use over an 8 Year Period.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009492.html