title: Pretransfer computed tomography delays arrival to definitive care without affecting pediatric trauma outcomes.
abstract: OBJECTIVE
  Children with thoracic or abdominal trauma, presenting to referring hospitals, may undergo CT imaging prior to transfer to a pediatric trauma center (PTC). We sought to determine if children who undergo pretransfer imaging experience a delay in definitive care and worse clinical outcomes.
  
  
  METHODS
  Pediatric blunt trauma patients transferred to our level I PTC were identified in this IRB approved study. Those transferred with CT imaging of the chest or abdomen/pelvis prior to transfer were compared to those transferred without imaging.
  
  
  RESULTS
  Of 246 patients with a mean age of 12.4±5.3years (64% male), 128 patients (52%) underwent chest (n=85) and/or abdominal (n=115) CT studies prior to transfer. Among those patients with pretransfer CT, 14% of CT scans were repeated. On multivariate analysis accounting for distance, time from injury to arrival at our PTC was significantly greater in children who underwent pretransfer CT (320±216 vs. 208±149minutes, p<0.001). Median length of stay (3 vs. 3days) and mortality (3% vs. 3%) were similar between groups (all p>0.05).
  
  
  CONCLUSIONS
  A substantial number of pediatric blunt trauma patients underwent CT scans prior to transfer, which is associated with a delay in transfer but not worse outcomes.
authors.affiliation: Department of Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA; Division of Pediatric Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA.
authors.forename: Aodhnait S
authors.initials: AS
authors.lastname: Fahy
authors.affiliation: Department of Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA; Division of Pediatric Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Antiel
authors.affiliation: Department of Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA; Division of Pediatric Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA.
authors.forename: Stephanie F
authors.initials: SF
authors.lastname: Polites
authors.affiliation: Department of Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA; Division of Pediatric Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Ishitani
authors.affiliation: Department of Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA; Division of Pediatric Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Moir
authors.affiliation: Department of Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA; Division of Trauma, Critical Care and General Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA. Electronic address: zielinski.martin@mayo.edu.
authors.forename: Martin D
authors.initials: MD
authors.lastname: Zielinski
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging* / Q000401:mortality; D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D010360:Patient Transfer; D012017:Referral and Consultation; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000000981:diagnostic imaging* / Q000401:mortality; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000401:mortality
keywords: Computer tomography; Injury; Pediatric trauma; Transfer