Pretransfer computed tomography delays arrival to definitive care without affecting pediatric trauma outcomes

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• 作者：Aodhnait S. Fahy^a ; ^b ; ¹ ; Ryan M. Antiel^a ; ^b ; ¹ ; Stephanie F. Polites^a ; ^b ; Michael B. Ishitani^a ; ^b ; Christopher R. Moir^a ; ^b ; Martin D. Zielinski^a ; ^c ; ^{zielinski.martin@mayo.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Pediatric trauma ; Computer tomography ; Transfer ; Injury
• 刊名：Journal of Pediatric Surgery
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：51
• 期：2
• 页码：323-325
• 全文大小：173 K

文摘

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 ± 5.3 years (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 ± 149 minutes, p < 0.001). Median length of stay (3 vs. 3 days) 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.