Pretransfer computed tomography delays arrival to definitive care without affecting pediatric trauma outcomes

Journal of Pediatric Surgery
Aodhnait S FahyMartin D Zielinski

Abstract

Children with thoracic or abdominal trauma, presenting to referring hospitals, may undergo CT imaging prior to transfer to a pediatric trauma center (PTC). We sought to determine if children who undergo pretransfer imaging experience a delay in definitive care and worse clinical outcomes. Pediatric blunt trauma patients transferred to our level I PTC were identified in this IRB approved study. Those transferred with CT imaging of the chest or abdomen/pelvis prior to transfer were compared to those transferred without imaging. Of 246 patients with a mean age of 12.4±5.3years (64% male), 128 patients (52%) underwent chest (n=85) and/or abdominal (n=115) CT studies prior to transfer. Among those patients with pretransfer CT, 14% of CT scans were repeated. On multivariate analysis accounting for distance, time from injury to arrival at our PTC was significantly greater in children who underwent pretransfer CT (320±216 vs. 208±149minutes, p<0.001). Median length of stay (3 vs. 3days) and mortality (3% vs. 3%) were similar between groups (all p>0.05). A substantial number of pediatric blunt trauma patients underwent CT scans prior to transfer, which is associated with a delay in transfer but not worse outcomes.

References

Dec 24, 2004·Journal of Pediatric Surgery·Stephen J FentonEric R Scaife
Jan 18, 2006·Journal of Pediatric Surgery·John C DensmoreKaren S Guice
Nov 30, 2007·The New England Journal of Medicine·David J Brenner, Eric J Hall
Dec 17, 2008·The Journal of Trauma·Cortney Y LeePaul A Kearney
Feb 1, 2012·Pediatrics·Kenneth D KochanekBernard Guyer
Jan 21, 2014·Journal of Pediatric Surgery·Leo Andrew BenedictWalter J Chwals

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Citations

May 19, 2017·The Journal of Trauma and Acute Care Surgery·Juan P GurriaRichard A Falcone

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