Letter to the Editor in Response to: Reducing Unnecessary Computed Tomography Scan

Abstract

We read with great interest the article entitled “Sustaining the gains: Reducing unnecessary computed tomography scans in pediatric trauma patients” submitted by Mahdi et al [ 1 Mahdi E Toscano N Pierson L Ndikumana E Ayers B Chacon A Brayer A Chess M Davis C Dorman R Livingston M Arca M Wakeman D Sustaining the gains: Reducing unnecessary computed tomography scans in pediatric trauma patients. J Pediatr Surg. 2023; 58: 111-117 Abstract Full Text Full Text PDF Scopus (0) Google Scholar ]. We congratulate the authors for their study describing their imaging algoritms in pediatric patients with blunt trauma. In 2016, their pediatric trauma team noticed the high frequency of CT scans in blunt trauma patients and sought to reduce unnecessary CT imaging. They found that 51% of CT scans performed on pediatric blunt trauma patients were not indicated. The CT scans that were not indicated by their guidelines found no injuries that warranted any specific treatment with the exception of clinical monitoring that would have been provided regardless of the injuries identified. In July 2017, their Pediatric Trauma Center prospectively implemented validated imaging guidelines to direct CT imaging for trauma activations and consultations for children younger than 16 years old with blunt traumatic injuries. They then compared CT scanning rates for pre-implementation and post-implementation time periods. During the pre-implementation time, 51% scans were not indicated by guidelines. During post-implementation, only 25% CT scans were not indicated. The total number of CT scans that were performed declined after initiation of guidelines (2.80 vs 1.46 scans/patient, p<0.0001). In conclusion, they state “this practice reduces harmful radiation exposure in a sensitive patient population and may save healthcare systems money and resources” [ 1 Mahdi E Toscano N Pierson L Ndikumana E Ayers B Chacon A Brayer A Chess M Davis C Dorman R Livingston M Arca M Wakeman D Sustaining the gains: Reducing unnecessary computed tomography scans in pediatric trauma patients. J Pediatr Surg. 2023; 58: 111-117 Abstract Full Text Full Text PDF Scopus (0) Google Scholar ].