Show simple item record

dc.contributor.authorBågenholm, Anna
dc.contributor.authorDehli, Trond
dc.contributor.authorHermansen, Stig Eggen
dc.contributor.authorBartnes, Kristian
dc.contributor.authorLarsen, Marthe
dc.contributor.authorIngebrigtsen, Tor
dc.date.accessioned2020-06-17T10:47:35Z
dc.date.available2020-06-17T10:47:35Z
dc.date.issued2020-01-10
dc.description.abstract<i>Background</i> - The International Commission on Radiological Protection’s (ICRP) justification principles state that an examination is justified if the potential benefit outweighs the risk for radiation harm. Computer tomography (CT) contributes 50% of the radiation dose from medical imaging, and in trauma patients, the use of standardized whole body CT (SWBCT) increases. Guidelines are lacking, and reviews conclude conflictingly regarding the benefit. We aimed to study the degree of adherence to ICRP’s level three justification, the individual dose limitation principle, in our institution.<p><p> <i>Methods</i> - This is a retrospective clinical audit. We included all 144 patients admitted with trauma team activation to our regional Level 1 trauma centre in 2015. Injuries were categorized according to the Abbreviated Injury Scale (AIS) codes. Time variables, vital parameters and interventions were registered. We categorized patients into trauma admission SWBCT, selective CT or no CT examination strategy groups. We used descriptive statistics and regression analysis of predictors for CT examination strategy.<p><p> <i>Results</i> - The 144 patients (114 (79.2%) males) had a median age of 31 (range 0–91) years. 105 (72.9%) had at least one AIS ≥ 2 injury, 26 (18.1%) in more than two body regions. During trauma admission, at least one vital parameter was abnormal in 46 (32.4%) patients, and 73 (50.7%) underwent SWBCT, 43 (29.9%) selective CT and 28 (19.4%) no CT examination. No or only minor injuries were identified in 17 (23.3%) in the SWBCT group. Two (4.6%) in the selective group were examined with a complement CT, with no new injuries identified. A significantly (<i>p</i> < <i>0.001</i>) lower proportion of children (61.5%) than adults (89.8%) underwent CT examination despite similar injury grades and use of interventions. In adjusted regression analysis, patients with a high-energy trauma mechanism had significantly (<i>p</i> = <i>0.028</i>) increased odds (odds ratio = 4.390, 95% confidence interval 1.174–16.413) for undergoing a SWBCT.<p><p> <i>Conclusion</i> - The high proportion of patients with no or only minor injuries detected in the SWBCT group and the significantly lower use of CT among children, indicate that use of a selective CT examination strategy in a higher proportion of our patients would have approximated the ICRP’s justification level three, the individual dose limitation principle, better.en_US
dc.identifier.citationBågenholm, Dehli, Hermansen, Bartnes, Larsen, Ingebrigtsen. Clinical guided computer tomography decisions are advocated in potentially severely injured trauma patients: a one-year audit in a level 1 trauma centre with long pre-hospital times. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2020en_US
dc.identifier.cristinIDFRIDAID 1812478
dc.identifier.doi10.1186/s13049-019-0692-5
dc.identifier.issn1757-7241
dc.identifier.urihttps://hdl.handle.net/10037/18584
dc.language.isoengen_US
dc.publisherBMCen_US
dc.relation.ispartofBågenholm, A. (2020). Trauma radiology in northern Norway. (Doctoral thesis). <a href=https://hdl.handle.net/10037/18962>https://hdl.handle.net/10037/18962</a>.
dc.relation.journalScandinavian Journal of Trauma, Resuscitation and Emergency Medicine
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2020 The Author(s)en_US
dc.subjectVDP::Medisinske Fag: 700en_US
dc.titleClinical guided computer tomography decisions are advocated in potentially severely injured trauma patients: a one-year audit in a level 1 trauma centre with long pre-hospital timesen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


File(s) in this item

Thumbnail

This item appears in the following collection(s)

Show simple item record