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

Abstract

PurposeChildren 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. MethodsPediatric 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. ResultsOf 246 patients with a mean age of 12.4±5.3years (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±149minutes, p<0.001). Median length of stay (3 vs. 3days) and mortality (3% vs. 3%) were similar between groups (all p>0.05). ConclusionsA 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.