Repeat computed tomography for trauma patients undergoing transfer to a Level I trauma center.
Our goal was to determine the characteristics of trauma transfer patients with repeat imaging. A retrospective trauma registry review was performed to evaluate trauma patients who were transferred from referring institutions between January 2005 and December 2009. Patients were divided  into those who had a duplicate computed tomography (CT) scan versus those who did not. There were 2678 patients included of whom 559 (21%) had at least one repeat CT scan, whereas 2119 (79%) did not have any repeat CT scans. Those with repeat CT scans were older (42.3 ± 27.3  years vs 37.3 ± 25.6 years), had a higher Injury Severity Score (ISS) (13.7 ± 8.7 vs 11.9 ± 8.8), and more likely to have blunt trauma (odds ratio, 4.7; confidence interval, 2.3 to 9.6) (P for all < 0.0007). Those with CT scans done only at the  referring facility were younger, had a lower ISS, and shorter lengths of stay (P for all < 0.0003). ISS and age were independent predictors for repeat CT scans. Transfer patients had imaging repeated one-fifth of the time. The younger, less injured patient went without repeat imaging  suggesting that they may have been adequately cared for at the outside institution.
Medical College of Virginia, Physicians and Hospitals, Virginia Commonwealth University Health System, Division of Trauma/Critical Care and Emergency Surgery, Richmond, Virginia, USA. ayoung3@mcvh-vcu.edu
Andrew Joseph
AJ
Young
Kenneth Sadler
KS
Meyers
Luke
L
Wolfe
Therese Marie
TM
Duane
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000639:trends; D008297:Male; D010360:Patient Transfer / Q000706:statistics & numerical data*; D012042:Registries; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000000981:diagnostic imaging* / Q000628:therapy