title: Trauma surgeon utilization of computerized tomography scanning: Room for improvement?
abstract: BACKGROUND
  We aimed to evaluate computerized tomography (CT) utilization and yield rates for trauma team activations (TTA).
  
  
  METHODS
  A retrospective review of all TTAs was conducted over nine months. TTAs consisted of two levels--trauma alert (TAL) and trauma response (TR). Yields of CT for significant findings (SF) for four CT types (brain, cervical, chest, abdomen/pelvis) were recorded.
  
  
  RESULTS
  647 patients were included. There was no difference in the utilization rates of CTs except for brain CTs (TAL, 98% vs TR, 94%, p = 0.008). There was no difference in the yield rates except for cervical spine CTs (TAL, 8% vs TR, 4%, p = 0.03). Over 80% received a pan scan regardless of TTA level; 63% who had any CT had no SF. The median ratio of scans with SF to the total number of scans per patient was 0.
  
  
  CONCLUSIONS
  Regardless of activation level, CT seems to be over utilized. More selective use of CT should be evaluated.
authors.affiliation: Department of Surgery, Section of Trauma and Acute Care Surgery, Reading Health System, Sixth Avenue and Spruce St, Reading, PA 19611, USA. Electronic address: adrian.ong@readinghealth.org.
authors.forename: Adrian W
authors.initials: AW
authors.lastname: Ong
authors.affiliation: Department of Surgery, Philadelphia College of Osteopathic Medicine, 4170 City Avenue, Philadelphia, PA 19131, USA.
authors.forename: Jeffery
authors.initials: J
authors.lastname: Moyer
authors.affiliation: Kutztown University of Pennsylvania, 15200 Kutztown Rd, Kutztown, PA 19530, USA.
authors.forename: Fikir D
authors.initials: FD
authors.lastname: Wordofa
authors.affiliation: Department of Emergency Medicine, Reading Health System, Sixth Avenue and Spruce St, Reading PA 1911, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Sigal
authors.affiliation: Department of Emergency Medicine, Reading Health System, Sixth Avenue and Spruce St, Reading PA 1911, USA.
authors.forename: Kristen
authors.initials: K
authors.lastname: Sandel
authors.affiliation: Department of Surgery, Section of Trauma and Acute Care Surgery, Reading Health System, Sixth Avenue and Spruce St, Reading, PA 19611, USA.
authors.forename: Forrest B
authors.initials: FB
authors.lastname: Fernandez
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010388:Pelvis / Q000000981:diagnostic imaging; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011860:Radiography, Abdominal; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D066231:Surgeons; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014193:Trauma Centers; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*
keywords: Computerized tomography; Missed injuries; Trauma team activation