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Analysis of Radiation Exposure in Trauma Patients at a Level I Trauma Center.
MedLine Citation:
PMID:  21536401     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Trauma patients are exposed to potentially high levels of low-dose radiation during radiologic studies. OBJECTIVES: To assess the cumulative effective dose (CED) of radiation exposure (RE) in 177 successive patients admitted to a trauma service from January 1 through February 28, 2006. RESULTS: Patients received a total of 1505 radiographs and 400 computed tomography (CT) scans in the study period. The CED was 14.56 mSv (0.97 mSv radiographs, 13.59 mSv CT scans) per patient total length of stay (LOS). CED averaged 8.66 mSv in the first hour and 11.76 mSv in the first 24 h after arrival. The most commonly performed CT scan was brain (n = 147), followed by abdomen and pelvis (n = 80), and cervical spine (n = 69). CT scans of the brain and cervical spine were the most commonly performed combined imaging tests (35%). Twelve percent of patients received no radiographs, and 15% received no CT scans. Six or more CT scans were done in 6% of patients. RE increased with longer LOS (> 6 days vs. 3-5 days vs. 1 day, p < 0.05). "Pan-scans" (a combination of CTs of the brain, cervical spine, chest, abdomen, and pelvis) were done in 13% (n = 23) of patients. There was a higher total RE from CT scans (25.09 mSv ± 19.48 mSv vs. 4.93 mSv ± 14.20 mSv) in patients with injury severity score (ISS) > 9 vs. ≤ 9 ( p < 0.0001). First hour and first 24-h RE rates from radiographs were lower in patients younger than 15 years vs. 15-45 years and older-than-45-year age cohorts (p < 0.05). CONCLUSIONS: In this study, CED was 14.56 mSv per patient. CT scans accounted for 21% of radiologic studies and 93% of CED. There was a higher CED rate in patients with ISS > 9 and longer LOS.
Authors:
Om P Sharma; Michael F Oswanski; Ramandeep Sidhu; Kerry Krugh; Amy Sue Culler; Matthew Spangler; Morgan Ethington; Heather A Stombaugh; Sherry K Lauer
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-30
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  -     ISSN:  0736-4679     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-5-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Trauma Services, The Toledo Hospital, Toledo, Ohio.
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