title: Burden of alcohol-related injuries on radiology services at a level I trauma center.
abstract: OBJECTIVE
  The purpose of our study was to evaluate the burden of alcohol-related injuries on a radiology department at a level 1 trauma center.
  
  
  METHODS
  We linked the trauma registry (2005-2009) of Harborview Medical Center to billing department data and extracted patient demographic and injury-related characteristics and the radiology services provided. Multivariate negative binomial analysis was used to evaluate the association between blood alcohol concentration (BAC) and CT and MRI utilization rates.
  
  
  RESULTS
  A total of 125,776 CT and 4681 MRI examinations were performed on 27,274 patients during the study period. Higher BAC was generally associated with higher utilization rates for all types of CT even after adjusting for potential confounding variables. Compared with patients with a BAC of 0, the greatest increases in utilization were observed in individuals with a BAC of 240 mg/dL or more for head CT (incidence rate ratio [IRR], 1.43; 95% CI, 1.32-1.54), cervical spine (IRR, 1.45; 95% CI, 1.32-1.58), and maxillofacial (IRR, 1.66; 95% CI, 1.42-1.95), with no increase observed for MRI. This association was more prominent in less severely injured patients with utilization rates for head CT (IRR, 1.83; 95% CI, 1.56-2.13), abdomen (IRR, 1.46; 95% CI, 1.32-1.63), and thorax (IRR, 1.57; 95% CI, 1.30-1.89) in individuals with a BAC of 240 mg/dL or more compared with those with a BAC of 0.
  
  
  CONCLUSIONS
  Higher BAC was associated with increased CT utilization for most body region-specific CT scans and was more strongly associated in patients with less severe injuries. Any guideline that could potentially decrease unnecessary imaging for patients with alcohol-involved injuries would represent a cost-saving strategy.
authors.affiliation: Comparative Effectiveness, Cost and Outcomes Research Center, Department of Radiology, University of Washington, Seattle, WA 98104, USA. roudsari@u.washington.edu
authors.forename: Bahman
authors.initials: B
authors.lastname: Roudsari
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Psoter
authors.forename: Christopher
authors.initials: C
authors.lastname: Mack
authors.forename: Monica S
authors.initials: MS
authors.lastname: Vavilala
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Jarvik
mesh_terms: D000328:Adult; D000431:Ethanol / Q000097:blood*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D012044:Regression Analysis; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000191:economics / Q000209:etiology*
chemical_list: D000431:Ethanol