Comparison Of Whole Body Computed Tomography (WBCT) Utilization Between Pediatric And Adult Trained Providers In Adolescent Trauma Activations
Bergthor Jonsson, Tyler W Ellis, *Denise B Klinkner, Aidan F Mulllan, James L Homme
Mayo Clinic, Rochester, MN
Prior studies have shown differences in the frequency of whole-body computed tomography (WBCT) between adult and pediatric trauma centers in age matched groups. At our combined pediatric and adult trauma center, adolescents follow the American College of Surgeonís criteria (>15 years). We hypothesized adolescents managed by the adult trauma team received more CTs than those managed by the pediatric trauma team with no change in management.
Our trauma registry was queried in a retrospective observational fashion for pediatric (12-14 years) and adult trauma activations (15-17 years) from 2015-2019. We excluded burn patients and patients in cardiac arrest upon arrival.
We identified 100 pediatric and 191 adult trauma team activations. Penetrating mechanisms were rare (5% vs 10%). Over 50% of injuries in both groups were blunt from motorized vehicles. There were 2 deaths in the younger group (2%) and 5 deaths in the older group (3%). No clinically significant injuries were missed on initial evaluation due to lack of CT imaging.
Similarly injured adolescents receive WBCT less frequently when managed by the pediatric trauma team. The practice of more conservative imaging does not seem to lead to any clinically significant missed injuries. Use of CT may be able to be tailored similarly for the older adolescents.
|Pediatric trauma team (age 12-14)||Adult trauma team (age 15-17)||Odds ratio||p-value|
|Whole-body CT total||21 (21%)||126 (66%)||7.29 (4.14 - 12.85)||< .001|
|Whole-body CT at our trauma center||9 (10%)||99 (57%)||11.89 (5.61 - 25.23)||< .001|
|Injury severity score mean (median)||9.4 (8.5)||11.0 (9)||0.439|
|ED length of stay mean (median) h:mm||2:31 (2:20)||2:31 (2:05)||0.682|
|Hospital length of stay mean (median)||3.5 (2) days||3.8 (2) days||0.621|
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