Investigating the Potential Overuse of Pan-Computed Tomography (PanCT) Examinations in Trauma Cases in Emergency Departments

<i>Background and Objectives:</i> The increasing use of whole-body computed tomography (WBCT) examinations, also known as panCT, in emergency departments for trauma patients has raised concerns about potential overuse and the associated risk of unnecessary radiation exposure. The purpose...

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Main Authors: Haitham Alahmad, Ahmed Hobani, Mohammed Alasmi, Abdulrhman M. Alshahrani, Ahmad Abanomy, Mohammad Alarifi, Abdulmajeed Alotaibi, Khaled Alenazi, Mansour Almanaa
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/60/11/1742
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author Haitham Alahmad
Ahmed Hobani
Mohammed Alasmi
Abdulrhman M. Alshahrani
Ahmad Abanomy
Mohammad Alarifi
Abdulmajeed Alotaibi
Khaled Alenazi
Mansour Almanaa
author_facet Haitham Alahmad
Ahmed Hobani
Mohammed Alasmi
Abdulrhman M. Alshahrani
Ahmad Abanomy
Mohammad Alarifi
Abdulmajeed Alotaibi
Khaled Alenazi
Mansour Almanaa
author_sort Haitham Alahmad
collection DOAJ
description <i>Background and Objectives:</i> The increasing use of whole-body computed tomography (WBCT) examinations, also known as panCT, in emergency departments for trauma patients has raised concerns about potential overuse and the associated risk of unnecessary radiation exposure. The purpose of this study was to examine the utilization patterns and findings of panCT scans performed over one year at a major academic hospital. <i>Materials and Methods</i>: This retrospective cohort study included 531 stable trauma adult patients who underwent panCT scans in 2023. De-identified data for each patient, including the radiology report, age, gender, and total dose-length product (DLP) of the panCT scan, were retrieved and reviewed. Radiology reports were classified based on the findings as negative (no acute traumatic injuries) or positive, with positive reports further subclassified based on injury location. Injury severity scores (ISS) were also calculated based on the findings of the radiology reports. Statistical analysis was performed using the Python programming language to assess any association between the independent variables (age and gender) and the dependent variable (report findings: negative or positive). <i>Results:</i> About 57% (n = 303) of the panCT scans included in the analysis were negative. The chi-squared test and logistic regression revealed a significant association between age and report finding (negative or positive), while no association with gender was found. One-third of positive cases (n = 72) had injuries only in the head and neck (H&N) region, and another one-third (n = 72) had injuries only in chest-abdomen-pelvis (CAP) region. Most cases (n = 373; 70%) had an ISS between 1 and 8, which is a mild score. <i>Conclusions:</i> This study showed a high rate of negative panCT scans, suggesting potential overuse of panCT. The study results highlight the need for more selective CT imaging approaches in emergency settings. Following evidence-based guidelines and decision-support tools could promote appropriate utilization of panCT scans, reducing unnecessary radiation exposure while ensuring that high-risk patients in emergency setting receive appropriate imaging.
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spelling doaj-art-dc67dd5aee6b4638baa4ac4f4dd3ccfb2024-11-26T18:12:12ZengMDPI AGMedicina1010-660X1648-91442024-10-016011174210.3390/medicina60111742Investigating the Potential Overuse of Pan-Computed Tomography (PanCT) Examinations in Trauma Cases in Emergency DepartmentsHaitham Alahmad0Ahmed Hobani1Mohammed Alasmi2Abdulrhman M. Alshahrani3Ahmad Abanomy4Mohammad Alarifi5Abdulmajeed Alotaibi6Khaled Alenazi7Mansour Almanaa8Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi ArabiaRadiology Department, University Medical City, King Saud University, Riyadh 12372, Saudi ArabiaRadiology Department, University Medical City, King Saud University, Riyadh 12372, Saudi ArabiaDepartment of Radiologic Technology, College of Applied Medical Sciences, Qassim University, P.O. BOX 6666, Buraydah 51452, Saudi ArabiaDepartment of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi ArabiaDepartment of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi ArabiaRadiological Sciences Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi ArabiaDepartment of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi ArabiaDepartment of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia<i>Background and Objectives:</i> The increasing use of whole-body computed tomography (WBCT) examinations, also known as panCT, in emergency departments for trauma patients has raised concerns about potential overuse and the associated risk of unnecessary radiation exposure. The purpose of this study was to examine the utilization patterns and findings of panCT scans performed over one year at a major academic hospital. <i>Materials and Methods</i>: This retrospective cohort study included 531 stable trauma adult patients who underwent panCT scans in 2023. De-identified data for each patient, including the radiology report, age, gender, and total dose-length product (DLP) of the panCT scan, were retrieved and reviewed. Radiology reports were classified based on the findings as negative (no acute traumatic injuries) or positive, with positive reports further subclassified based on injury location. Injury severity scores (ISS) were also calculated based on the findings of the radiology reports. Statistical analysis was performed using the Python programming language to assess any association between the independent variables (age and gender) and the dependent variable (report findings: negative or positive). <i>Results:</i> About 57% (n = 303) of the panCT scans included in the analysis were negative. The chi-squared test and logistic regression revealed a significant association between age and report finding (negative or positive), while no association with gender was found. One-third of positive cases (n = 72) had injuries only in the head and neck (H&N) region, and another one-third (n = 72) had injuries only in chest-abdomen-pelvis (CAP) region. Most cases (n = 373; 70%) had an ISS between 1 and 8, which is a mild score. <i>Conclusions:</i> This study showed a high rate of negative panCT scans, suggesting potential overuse of panCT. The study results highlight the need for more selective CT imaging approaches in emergency settings. Following evidence-based guidelines and decision-support tools could promote appropriate utilization of panCT scans, reducing unnecessary radiation exposure while ensuring that high-risk patients in emergency setting receive appropriate imaging.https://www.mdpi.com/1648-9144/60/11/1742overusecomputed tomographywhole-body CTpolytraumapanCT
spellingShingle Haitham Alahmad
Ahmed Hobani
Mohammed Alasmi
Abdulrhman M. Alshahrani
Ahmad Abanomy
Mohammad Alarifi
Abdulmajeed Alotaibi
Khaled Alenazi
Mansour Almanaa
Investigating the Potential Overuse of Pan-Computed Tomography (PanCT) Examinations in Trauma Cases in Emergency Departments
Medicina
overuse
computed tomography
whole-body CT
polytrauma
panCT
title Investigating the Potential Overuse of Pan-Computed Tomography (PanCT) Examinations in Trauma Cases in Emergency Departments
title_full Investigating the Potential Overuse of Pan-Computed Tomography (PanCT) Examinations in Trauma Cases in Emergency Departments
title_fullStr Investigating the Potential Overuse of Pan-Computed Tomography (PanCT) Examinations in Trauma Cases in Emergency Departments
title_full_unstemmed Investigating the Potential Overuse of Pan-Computed Tomography (PanCT) Examinations in Trauma Cases in Emergency Departments
title_short Investigating the Potential Overuse of Pan-Computed Tomography (PanCT) Examinations in Trauma Cases in Emergency Departments
title_sort investigating the potential overuse of pan computed tomography panct examinations in trauma cases in emergency departments
topic overuse
computed tomography
whole-body CT
polytrauma
panCT
url https://www.mdpi.com/1648-9144/60/11/1742
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