CT Utilization in Transferred Trauma Patients

Abstract

Trauma systems were designed to optimize care of critically injured patients. CT scanning and its duplication demonstrate waste, inefficiency, and harm to the patient. We define the frequency at which this occurs and identify areas of inefficiency within our system that may be present in other systems. Patients transferred to a level I trauma center were prospectively identified at the time of transfer. All imaging completed at either the referring center or the level I center was recorded. The reason for CT scanning at the level I center was captured at the time of decision and recorded in one of four categories. A total of 207 transferred trauma patients with CT imaging were reviewed. Of these, 127 patients (61%) had CT scans obtained at both the referring and accepting facilities; 99 patients (48%) had one or more of the same body regions imaged at both centers; 28 (13%) patients did not have repeated body region scans, but received additional imaging at the Trauma Center. CT scans of the head (34%) and c-spine (35%) were most commonly obtained at both the referring center and the trauma center. The most common reason for repeat or additional imaging at the trauma center was improper image selection or poor image quality. Repeat and additional imaging of transferred trauma patients is a common practice. The reasons for this include image quality and selection. This provides necessary information for improvement in the quality of the trauma transfer process.