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Radiation exposure has increased in trauma patients over time.

Published on Feb 1, 2012in Journal of Trauma-injury Infection and Critical Care
· DOI :10.1097/TA.0b013e31823c59ee
Kasra Ahmadinia2
Estimated H-index: 2
,
J. Smucker1
Estimated H-index: 1
+ 1 AuthorsHeather A. Vallier22
Estimated H-index: 22
Abstract
Background:Computed tomography (CT) scans have become imaging modalities of choice in trauma centers. The purposes of this study were to evaluate the trend of radiation exposure in acute trauma patients. Our hypothesis was that radiation dosage and charges would increase over time without change in
  • References (28)
  • Citations (27)
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References28
Newest
#1Deborah L Mueller (University of Texas Health Science Center at San Antonio)H-Index: 9
#2Mustapha R. Hatab (University of Texas Health Science Center at San Antonio)H-Index: 13
Last. Ronald M. Stewart (University of Texas Health Science Center at San Antonio)H-Index: 31
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Background: Increased utilization of computed tomography (CT) scans for evaluation of blunt trauma patients has resulted in increased doses of radiation to patients. Radiation dose is relatively amplified in children secondary to body size, and children are more susceptible to long-term carcinogenic effects of radiation. Our aim was to measure radiation dose received in pediatric blunt trauma patients during initial CT evaluation and to determine whether doses exceed doses historically correlate...
43 CitationsSource
#1John J. Como (MetroHealth)H-Index: 26
#2William H. Leukhardt (MetroHealth)H-Index: 1
Last. Jeffrey A. ClaridgeH-Index: 31
view all 6 authors...
Background:Cervical spine (CS) clearance in obtunded blunt trauma patients (OBTPs) remains controversial. When computed tomography (CT) of the CS is negative for injury, debate continues over the role of magnetic resonance imaging (MRI). Use of MRI in OBTPs is costly, time-consuming, and potentially
41 CitationsSource
1 CitationsSource
#1Shi-Ting Feng (SYSU: Sun Yat-sen University)H-Index: 8
#2Martin Law (Queen Mary Hospital)H-Index: 11
Last. Pek-Lan Khong (HKU: University of Hong Kong)H-Index: 43
view all 7 authors...
Objective: To measure the radiation dose from CT scans in an anthropomorphic phantom using a 64-slice MDCT, and to estimate the associated cancer risk. Materials and methods: Organ doses were measured with a 5-year-old phantom and thermoluminescent dosimeters. Four protocols; head CT, thorax CT, abdomen CT and pelvis CT were studied. Cancer risks, in the form of lifetime attributable risk (LAR) of cancer incidence, were estimated by linear extrapolation using the organ radiation doses and the LA...
54 CitationsSource
#1Frederick K. Korley (Johns Hopkins University)H-Index: 14
#2Julius Cuong Pham (Johns Hopkins University)H-Index: 26
Last. Thomas D. Kirsch (Johns Hopkins University)H-Index: 24
view all 3 authors...
[95% CI, 4.9%-6.9%] in 1998 and 5.5% [95% CI, 4.7%-6.5%] in 2007; P=.50 for trend) or to an intensive care unit (0.62% [95% CI, 0.40%-1.00%] in 1998 and 0.80% [95% CI, 0.53%-1.21%] in 2007; P=.14 for trend). Visits during which CT or MRI was obtained lasted 126 minutes (95% CI, 123-131 minutes) longer than those for which CT or MRI was not obtained.
245 CitationsSource
#1Joshua Broder (Duke University)H-Index: 14
#2Caroline L. Hollingsworth (Duke University)H-Index: 12
Last. Erik K. Paulson (Duke University)H-Index: 55
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Study objective Computed tomography (CT) is increasingly used for emergency department (ED) patients with abdominal tenderness. CT-related radiation contributes to 2% of US cancers. We hypothesized that in the ED patient with nontraumatic abdominal tenderness, the tender region accurately delineates acute pathology. z axis–restricted CT guided by this region could detect pathology while reducing radiation dose. Methods This was a prospective double-blinded observational trial with informed conse...
15 CitationsSource
#1Tara A. Morgan (UMB: University of Maryland, Baltimore)H-Index: 7
#2Scott D. Steenburg (UMB: University of Maryland, Baltimore)H-Index: 10
Last. Stuart E. Mirvis (UMB: University of Maryland, Baltimore)H-Index: 50
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The management of acute traumatic aortic injuries is reviewed, and normal and abnormal findings seen at follow-up CT after both endovascular repair and surgical repair are described and illustrated.
18 CitationsSource
Background: Conventional C-spine imaging (3-view series) is still widely used in trauma patients, although the utilization of computed tomography (CT) scanning is increasing. The aim of this study was to analyze the value of conventional radiography and the frequency of subsequent CT scanning due to incompleteness of three-view series of the C-spine in adult blunt trauma patients. Methods: We analyzed the data of a prospectively collected database including all patients between November 2005 and...
7 CitationsSource
#1Rebecca Smith-Bindman (UCSF: University of California, San Francisco)H-Index: 40
#2Jafi A. Lipson (UCSF: University of California, San Francisco)H-Index: 14
Last. Diana L. Miglioretti (UW: University of Washington)H-Index: 63
view all 8 authors...
Background Use of computed tomography (CT) for diagnostic evaluation has increased dramatically over the past 2 decades. Even though CT is associated with substantially higher radiation exposure than conventional radiography, typical doses are not known. We sought to estimate the radiation dose associated with common CT studies in clinical practice and quantify the potential cancer risk associated with these examinations. Methods We conducted a retrospective cross-sectional study describing radi...
1,422 CitationsSource
#2A.R. van Geene (Harborview Medical Center)H-Index: 1
Last. J.C. GoslingsH-Index: 12
view all 6 authors...
Abstract Introduction While computed tomography (CT) scan usage in acute trauma patients is currently part of the standard complete diagnostic workup, little is known regarding the time factors involved when CT scanning is added to the standard workup. An analysis of the current time factors and intervals in a high-volume, streamlined level-1 trauma center can potentially expose points of improvement in the trauma resuscitation phase. Materials and methods During a 5-week period, data on current...
26 CitationsSource
Cited By27
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#1Christian David Weber (RWTH Aachen University)H-Index: 5
#2Jana Kristina Schmitz (RWTH Aachen University)
Last. Philipp Kobbe (RWTH Aachen University)H-Index: 22
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Introduction The purpose of this study was to investigate the effects of alcohol intoxication in trauma patients in regard to its impact on application of computed tomography (CT) and associated radiation exposure.
Source
#1C.K. Hansen (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 3
#2Reuben J. StrayerH-Index: 5
Last. Kaushal Shah (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 16
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Purpose The rise of computed tomography (CT) use in trauma has become the subject of concern given the harms of CT including radiation, cost, over diagnosis and identification of incidental lesions. We developed a novel metric, the Negative CT Score, (∑CT−) which quantifies how often CT imaging identifies important injuries. Our objective was to describe the pattern of CT utilization in trauma at an urban academic level one trauma center using this novel metric.
4 CitationsSource
#1Michele Catapano (University of Milan)H-Index: 1
#2Domenico Albano (University of Palermo)H-Index: 11
Last. Luca Maria Sconfienza (University of Milan)H-Index: 25
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Abstract Introduction During night and on weekends, in our emergency department there is no radiologist on duty or on call: thus, X-ray examinations (XR) are evaluated by the orthopaedic surgeon on duty and reported the following morning/monday by radiologists. The aim of our study was to examine the discrepancy rate between orthopaedists and radiologists in the interpretation of imaging examinations performed on patients in our tertiary level orthopaedic institution and the consequences of dela...
3 CitationsSource
#1Thomas MistralH-Index: 1
Last. Pierre BouzatH-Index: 24
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Source
#1Kerri A. Van Arnem (San Antonio Military Medical Center)H-Index: 1
#2David P. Supinski (San Antonio Military Medical Center)H-Index: 1
Last. Shawn M. Varney (San Antonio Military Medical Center)H-Index: 8
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Abstract Background Trauma patients sustaining blunt injuries are exposed to multiple radiologic studies. Evidence indicates that the risk of cancer from exposure to ionizing radiation rises in direct proportion to the cumulative effective dose (CED) received. The purpose of this study is to quantify the amount of ionizing radiation accumulated when arriving directly from point of injury to San Antonio Military Medical Center (SAMMC), a level I trauma center, compared with those transferred from...
2 CitationsSource
#1Zhi-Jie HongH-Index: 5
#2Cheng-JuengChenH-Index: 17
Last. Sheng-Der HsuH-Index: 7
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AbstractWe aimed to evaluate the benefit of whole-body computed tomography (WBCT) scanning for unconscious adult patients suffering from high-energy multiple trauma compared with the conventional stepwise approach of organ-selective CT.Totally, 144 unconscious patients with high-energy multiple trau
2 CitationsSource
#1Gregory E. Tong (UCSF: University of California, San Francisco)H-Index: 2
#2Kristan Staudenmayer (Stanford University)H-Index: 19
Last. Renee Y. Hsia (UCSF: University of California, San Francisco)H-Index: 33
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Background Advanced radiographic studies have detrimental risks, yet the prevalence of CT utilization in patients with minor trauma presenting to the emergency department (ED) has never been fully evaluated. Our objective was to evaluate the frequency of CT imaging in patients presenting to the ED for minor trauma. Materials and methods A retrospective analysis of the California Office of Statewide Health Planning and Development Emergency Department and Ambulatory Surgery Data from 2005 to 2013...
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Abstract Aim Over-triage rates related to the use of Vittel criteria are unknown. We compared severe stable trauma patients with and without significant visceral injuries. Study design A single-centre retrospective analysis of a single-centre prospective cohort. Patients and methods Trauma patients with at least one positive Vittel criterion from June 2010 to January 2012 in a level-1 trauma centre. Initial management included a systematic whole-body scanner. All significant lesions in stable tr...
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AbstractMost Emergency Medical Services (EMS) protocols require spine immobilization with both a cervical collar and long spine board for patients with suspected spine injuries. The goal of this research was to determine the prevalence of unstable thoracolumbar spine injuries among patients receiving prehospital spine immobilization: a 4-year retrospective review of adult subjects who received prehospital spine immobilization and were transported to a trauma center. Prehospital and hospital reco...
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