title: Blunt trauma and the role of routine pelvic radiographs.
abstract: We evaluated clinical factors that are predictive of pelvic X-ray findings. We sought to identify whether routine pelvic films are necessary in blunt trauma and addressed whether removal of these films would minimize cost. We performed a retrospective chart review of 111 patients without pelvic fractures and 108 with pelvic fractures seen at our Level 1 trauma center between August 1998 and September 1999. We evaluated initial hemodynamics, physical examination findings, laboratory data, and hospital charges. Patients with fractures had higher Injury Severity Scores (P < 0.001), a higher number of associated injuries (P < 0.001), and lower blood pressures (P < 0.001). The back and pelvic examinations were significantly associated with X-ray results (P < 0.001), and the potential savings with selective radiography was $168,300.00 per year. We believe that clinical factors identified in our study predict the need for pelvic X-ray. Because removal of these films would minimize cost we recommend the elimination of routine pelvic films for the awake and alert blunt trauma patient.
authors.affiliation: Department of Surgery, Eastern Virginia Medical School, Norfolk 23507, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Duane
authors.forename: F J
authors.initials: FJ
authors.lastname: Cole
authors.forename: L J
authors.initials: LJ
authors.lastname: Weireter
authors.forename: L D
authors.initials: LD
authors.lastname: Britt
mesh_terms: D000328:Adult; D001415:Back / Q000000981:diagnostic imaging; D017046:Cost Savings; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries; D010388:Pelvis / Q000000981:diagnostic imaging* / Q000293:injuries; D011237:Predictive Value of Tests; D011859:Radiography / Q000191:economics; D012189:Retrospective Studies; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000191:economics