Document Detail


Organ laceration grading adherence by radiologists.
MedLine Citation:
PMID:  25301373     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
American Association for the Surgery of Trauma (AAST) abdominopelvic organ laceration grading is used to determine which patients can be managed non-operatively. We assess a change in the use of AAST grading system by radiologists at a single, large, academic institution before and after a one-time departmental intervention and reviewed non-graded reports evaluating if grading could be inferred. After IRB approval, a keyword search for "laceration" identified traumatic abdominopelvic CT reports in a 2-year period before and after the one-time intervention. Reports were reviewed to determine if an organ laceration was seen, if it was graded by AAST criteria, and if grading could be inferred for non-graded reports. T test was performed to assess statistical significance. Before the intervention, 348 reports contained the keyword "laceration," 81 with lacerations, 31 graded (38 %). After the intervention, 302 reports were found, 79 with lacerations, 59 graded (75 %). The increase was statistically significant (p < 0.0001). A decreasing trend in grading was seen over time following the intervention. Two out of 50 (4 %) pre-intervention and four out of 20 (20 %) post-intervention reports gave enough detailed descriptions for the grading to be inferred when it was not explicitly stated. Non-graded reports did not describe laceration parenchymal depth and subcapsular hematoma surface area percentage; however, the presence/absence of active extravasation, omitted in the 20-year-old AAST grading scheme, was described in every report. One-time departmental intervention yielded a significant increase in adherence to AAST laceration grading. Lack of perfect compliance, which diminished over time, suggests a need for further reinforcement.
Authors:
Vivek Bihari Kalra; Xiao Wu; Jamal Bokhari; Howard Forman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-10
Journal Detail:
Title:  Emergency radiology     Volume:  -     ISSN:  1438-1435     ISO Abbreviation:  Emerg Radiol     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-10     Completed Date:  -     Revised Date:  2014-10-11    
Medline Journal Info:
Nlm Unique ID:  9431227     Medline TA:  Emerg Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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