title: Analysis of radiation exposure in trauma patients at a level I trauma center.
abstract: BACKGROUND
  Trauma patients are exposed to potentially high levels of low-dose radiation during radiologic studies.
  
  
  OBJECTIVE
  To assess the cumulative effective dose (CED) of radiation exposure (RE) in 177 successive patients admitted to a trauma service from January 1 through February 28, 2006.
  
  
  RESULTS
  Patients received a total of 1505 radiographs and 400 computed tomography (CT) scans in the study period. The CED was 14.56 mSv (0.97 mSv radiographs, 13.59 mSv CT scans) per patient total length of stay (LOS). CED averaged 8.66 mSv in the first hour and 11.76 mSv in the first 24 h after arrival. The most commonly performed CT scan was brain (n = 147), followed by abdomen and pelvis (n = 80), and cervical spine (n = 69). CT scans of the brain and cervical spine were the most commonly performed combined imaging tests (35%). Twelve percent of patients received no radiographs, and 15% received no CT scans. Six or more CT scans were done in 6% of patients. RE increased with longer LOS (> 6 days vs. 3-5 days vs. 1 day, p < 0.05). "Pan-scans" (a combination of CTs of the brain, cervical spine, chest, abdomen, and pelvis) were done in 13% (n = 23) of patients. There was a higher total RE from CT scans (25.09 mSv ± 19.48 mSv vs. 4.93 mSv ± 14.20 mSv) in patients with injury severity score (ISS) > 9 vs. ≤ 9 ( p < 0.0001). First hour and first 24-h RE rates from radiographs were lower in patients younger than 15 years vs. 15-45 years and older-than-45-year age cohorts (p < 0.05).
  
  
  CONCLUSIONS
  In this study, CED was 14.56 mSv per patient. CT scans accounted for 21% of radiologic studies and 93% of CED. There was a higher CED rate in patients with ISS > 9 and longer LOS.
authors.affiliation: Trauma Services, The Toledo Hospital, Toledo, Ohio, USA.
authors.forename: Om P
authors.initials: OP
authors.lastname: Sharma
authors.forename: Michael F
authors.initials: MF
authors.lastname: Oswanski
authors.forename: Ramandeep
authors.initials: R
authors.lastname: Sidhu
authors.forename: Kerry
authors.initials: K
authors.lastname: Krugh
authors.forename: Amy Sue
authors.initials: AS
authors.lastname: Culler
authors.forename: Matthew
authors.initials: M
authors.lastname: Spangler
authors.forename: Morgan
authors.initials: M
authors.lastname: Ethington
authors.forename: Heather A
authors.initials: HA
authors.lastname: Stombaugh
authors.forename: Sherry K
authors.initials: SK
authors.lastname: Lauer
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000000981:diagnostic imaging*; D055815:Young Adult