title: Facial imaging in an urban emergency department.
abstract: To describe the facial imaging practice pattern in our an emergency department and to assess the implications of this practice, a retrospective review was conducted of patients with blunt facial trauma requiring facial imaging over a 2-month period. Patients were compared based on their initial imaging study, either facial x-rays (primary FXR) or spiral computed tomography (primary FSCT). Of 211 patients imaged, 148 (70%) received primary FXR and 63 (30%) primary FSCT. A greater proportion of primary FSCT patients had at least one fracture detected (57% v. 26%; odds ratio 3.9, confidence interval 2.0-7.5). Of patients with a fracture on FXR, 29% underwent secondary FSCT. The average facial imaging charges per case detected (patient with a fracture) were $978 for primary FXR and $2,048 for primary FSCT. Physicians made avid use of FSCT. Additional studies are needed to determine the appropriateness of this practice and to improve clinical selection of patients requiring FSCT.
authors.affiliation: Department of Surgery, Emory University School of Medicine, Atlanta, GA 30303, USA.
authors.forename: W S
authors.initials: WS
authors.lastname: Pearl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005151:Facial Injuries / Q000000981:diagnostic imaging*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011859:Radiography / Q000191:economics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000706:statistics & numerical data