Aodhnait S Fahy1, Ryan M Antiel1, Stephanie F Polites1, Michael B Ishitani1, Christopher R Moir1, Martin D Zielinski2. 1. Department of Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA; Division of Pediatric Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA. 2. Department of Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA; Division of Trauma, Critical Care and General Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA. Electronic address: zielinski.martin@mayo.edu.
Abstract
PURPOSE: Children 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. METHODS: Pediatric 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. RESULTS: Of 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). CONCLUSIONS: A 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.
PURPOSE:Children 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. METHODS:Pediatric blunt traumapatients 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. RESULTS: Of 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). CONCLUSIONS: A substantial number of pediatric blunt traumapatients underwent CT scans prior to transfer, which is associated with a delay in transfer but not worse outcomes.
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