Current utilization and radiation dose from computed tomography in patients with trauma.
OBJECTIVE
To quantify the cumulative effective dose of radiation received during hospitalization after traumatic injury and to compare the computed tomography (CT) utilization practices for two time periods in patients with trauma.


METHODS
A retrospective analysis of radiologic and medical data.


METHODS
A level I trauma center.


METHODS
Consecutively admitted adult patients with trauma with moderate to severe injuries (injury severity score >8), an intensive care unit (ICU) length of stay of one or more days, who were directly admitted and not transferred to another acute care center.


RESULTS
CT examination means and utilization were compared for April through August, 2003 and April to August, 2007. Cumulative effective doses were calculated for the 2007 period, and patients with a high radiation dose (>100 mSv) were identified. One hundred sixty-five adult patients with trauma were included. An increase in mean CT examinations per patient was observed in the 2007 period compared with the 2003 period, overall (4.41 vs. 3.44, p = 0.002) and among subsets of patients. The overall increase remained significant after adjustment for patient demographics (p = 0.05). The mean cumulative effective dose per patient was 11.13 mSv in 2007; 9% of patients received a dose >or=100 mSv.


CONCLUSIONS
Patients with trauma are at an increased risk of adverse effects from CT studies, because they receive high doses of radiation, and the number of CT examinations that patients receive is increasing with time. We recommend that risk of radiation be prospectively monitored and estimated by hospitals through the use of CT examination count per patient.
Salottolo
Kristin
K
Department of Trauma Research, Swedish Medical Center, Englewood, CO, USA.
Bar-Or
Raphael
R
Fleishman
Matthew
M
Maruyama
Gen
G
Slone
Denetta Sue
DS
Mains
Charles W
CW
Bar-Or
David
D
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000000981:diagnostic imaging*