title: Declining trend in the use of repeat computed tomography for trauma patients admitted to a level I trauma center for traffic-related injuries.
abstract: OBJECTIVE
  To evaluate the trend in utilization of repeat (i.e. ≥2) computed tomography (CT) and to compare utilization patterns across body regions for trauma patients admitted to a level I trauma center for traffic-related injuries (TRI).
  
  
  METHODS
  We linked the Harborview Medical Center trauma registry (1996-2010) to the billing department data. We extracted the following variables: type and frequency of CTs performed, age, gender, race/ethnicity, insurance status, injury mechanism and severity, length of hospitalization, intensive care unit (ICU) admission and final disposition. TRIs were defined as motor vehicle collisions, motorcycle, bicycle and pedestrian-related injuries. Logistic regression was used to evaluate the association between utilization of different body region repeat (i.e. ≥2) CTs and year of admission, adjusting for patient and injury-related characteristics that could influence utilization patterns.
  
  
  RESULTS
  A total of 28,431 patients were admitted for TRIs over the study period and 9499 (33%) received repeat CTs. From 1996 to 2010, the proportion of patients receiving repeat CTs decreased by 33%. Relative to 2000 and adjusting for other covariates, patients with TRIs admitted in 2010 had significantly lower odds of undergoing repeat head (OR=0.61; 95% CI: 0.49-0.76), pelvis (OR=0.37; 95% CI: 0.27-0.52), cervical spine (OR=0.23; 95% CI: 0.12-0.43), and maxillofacial CTs (OR=0.24; 95% CI: 0.10-0.57). However, they had higher odds of receiving repeat thoracic CTs (OR=1.86; 95% CI: 1.02-3.38).
  
  
  CONCLUSIONS
  A significant decrease in the utilization of repeat CTs was observed in trauma patients presenting with traffic-related injuries over a 15-year period.
authors.affiliation: Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195, United States. kevinp2@u.washington.edu
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Psoter
authors.forename: Bahman S
authors.initials: BS
authors.lastname: Roudsari
authors.forename: Janessa M
authors.initials: JM
authors.lastname: Graves
authors.forename: Christopher
authors.initials: C
authors.lastname: Mack
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Jarvik
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data* / Q000639:trends; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data* / Q000639:trends*; D014193:Trauma Centers / Q000706:statistics & numerical data* / Q000639:trends; D015599:Trauma Severity Indices; D014600:Utilization Review; D014861:Washington / Q000453:epidemiology; D014947:Wounds and Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D055815:Young Adult