To identify the number of CT scans repeated in acute trauma patients receiving imaging before being referred to a trauma center, to define indications, and to assess radiation doses and costs of repeated CT.METHOD AND MATERIALS
This retrospective study included all adult trauma patients transferred from other hospitals to a Level-I trauma center during 2014. Indications for repeated CT scans were categorized into: inadequate CT image data transfer, poor image quality, repetition of head CT after head injury together with completion to whole-body CT (WBCT), and follow-up of injury known from previous CT. Radiation doses from repeated CT were determined; costs were calculated using.RESULTS
Within one year, 85/298 (28.5%) trauma patients were transferred from another hospital because of severe head injury (n=45, 52.9%) and major body trauma (n=23; 27.1%) not manageable in the referring hospital, repatriation from a foreign country (n=14; 16.5%), and no ICU-capacity (n=3; 3.5%). Of these 85 patients, 74 (87.1%) had repeated CT in our center because of inadequate CT data transfer (n=29; 39.2%), repetition of head CT with completion to WBCT (n=24; 32.4%), and follow-up of known injury (n=21; 28.4%). None occurred because of poor image quality. Cumulative DLP and annual costs of potential preventable, repeated CT (inadequate data transfer) was 631mSv (81’304mGy*cm) and 40’192$, respectively.The mean time from trauma to admission to our center was significantly shorter in patients without repeated CT (median 1.5 ± 3 hours) as compared to those with repeated CT (median 3.0 ± 19 hours, p<0.001).CONCLUSION
A considerable number of transferred trauma patients undergo potentially preventable, repeated CT, adding radiation dose to patients and costs to the health care system.CLINICAL RELEVANCE/APPLICATION
Repetition of CT in trauma patients occurs relatively often and mainly is caused by inadequate image data transfer.