TY - JOUR
T1 - Changes in thoracolumbar computed tomography and radiography utilization among trauma patients after deployment of multidetector computed tomography in the emergency department
AU - Griffey, Richard T.
AU - Ledbetter, Stephen
AU - Khorasani, Ramin
PY - 2007/5/1
Y1 - 2007/5/1
N2 - 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.
AB - 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.
KW - Diagnostic imaging
KW - Physician's practice patterns
KW - Spinal injuries
KW - Spiral computed tomography
KW - Trauma centers
UR - http://www.scopus.com/inward/record.url?scp=34248372905&partnerID=8YFLogxK
U2 - 10.1097/01.ta.0000200818.58534.5a
DO - 10.1097/01.ta.0000200818.58534.5a
M3 - Review article
C2 - 17495716
AN - SCOPUS:34248372905
SN - 0022-5282
VL - 62
SP - 1153
EP - 1156
JO - Journal of Trauma - Injury, Infection and Critical Care
JF - Journal of Trauma - Injury, Infection and Critical Care
IS - 5
ER -