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The Impact of Pre-Transfer CT Scans on Pediatric Trauma Outcomes
Ryan M. Antiel, MD, Stephanie F. Polites, MD, Aodhnait S. Fahy, BMBCh, PhD, Michael B. Ishitani, MD, Christopher R. Moir, MD and Martin D. Zielinski, MD, Mayo Clinic, Rochester MN

Abstract:
Purpose:
Children with suspected blunt thoracic or abdominal trauma presenting to referring hospitals may undergo CT imaging prior to transfer to a pediatric trauma center (PTC). Our purpose was to determine if children who undergo pre-transfer imaging experience a delay in definitive care and worse outcomes. Methods: We reviewed pediatric blunt trauma patients transferred to our level I PTC from 2009 to 2013. Those who underwent CT of the chest or abdomen prior to transfer were compared to those transferred without imaging. Results: 246 patients were reviewed with a mean age of 12.4�5.3 years (64% male). 128 patients (52%) underwent chest (n=85) or abdominal (n=115) CT prior to transfer. 118 patients were transferred without CT and subsequently underwent chest (n=83) or abdominal (n=109) CT imaging upon arrival. Among those patients with pre-transfer CT, repeat scans were required in 9%. Mean injury severity scores were similar between groups (14.5�9.5 vs. 12.4�8.9, p=0.07). Time from injury to arrival at our PTC was significantly greater in children who underwent pre-transfer CT (320�216 vs. 208�149 minutes, p0.05). Conclusions: A substantial number of pediatric blunt trauma patients continue to undergo CT scans prior to transfer. CT prior to transfer is associated with a delay in definitive care of blunt thoracic and abdominal trauma in children. This delay does not appear to impact outcomes.
Objective:
In this presentation we will discuss outcomes of pediatric blunt trauma patients who undergo CT scans prior to transfer. At the end of the presentation, the learner will be able to report the frequency of pre-transfer CT scans as well as the impact on transfer times and outcomes.
Objective Content: Over half of suspected blunt thoracic or abdominal trauma patients underwent pre-transfer CT scans. Imaging prior to transfer is associated with a delay in definitive care but does not appear to impact various outcomes.


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