Trauma surgeon utilization of computerized tomography scanning: Room for improvement?

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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.