Changes in thoracolumbar computed tomography and radiography utilization among trauma patients after deployment of multidetector computed tomography in the emergency department

Richard T. Griffey, Stephen Ledbetter, Ramin Khorasani

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations

Abstract

BACKGROUND: Diagnostic-quality thoracolumbar spine (TLS) images, generated from routine thoracoabdominal multidetector computed tomography (MDCT) data, have been demonstrated superior to conventional radiography (CR) for TLS injury. We evaluated thoracoabdominal computed tomography (CT) and TLS utilization among trauma patients after deployment of MDCT. We hypothesized that reformatted MDCT images replaced CR for evaluation of TLS trauma among patients undergoing chest or abdominal CT, and that utilization of thoracoabdominal CT and TLS screening in trauma increased postMDCT. METHODS: We reviewed all TLS imaging for trauma patients undergoing chest or abdominal CT for 18 months pre- and postMDCT. We compared the relative use of CR and CT in TLS imaging, and the volume of TLS screening, and chest and abdominal CT across the study period. We also reviewed TLS CR in patients not undergoing chest or abdominal CT. RESULTS: After MDCT deployment, CT replaced CR for TLS imaging among those undergoing chest or abdominal CT for trauma. Utilization of chest and abdominal CT and TLS screening significantly increased, despite unchanged volume and severity of trauma patients during the study period. There was a corresponding decrease in patients evaluated with thoracic spine CR alone CONCLUSIONS: Reformatted TLS images using thoracoabdominal CT data have replaced CR in our evaluation of TLS trauma. However, reasons for increased utilization remain unclear. Further studies are needed to determine whether clinical yield and cost-effectiveness warrant these changes in utilization.

Original languageEnglish
Pages (from-to)1153-1156
Number of pages4
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume62
Issue number5
DOIs
StatePublished - May 1 2007

Keywords

  • Diagnostic imaging
  • Physician's practice patterns
  • Spinal injuries
  • Spiral computed tomography
  • Trauma centers

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