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Is computerized tomography of trauma patients associated with a transfer delay to a regional trauma centre?

Published online by Cambridge University Press:  21 May 2015

Justin Onzuka ,
Andrew Worster  and
Bill McCreadie
Justin Onzuka
Affiliation:
Division of Emergency Medicine, McMaster University, Hamilton, Ont.
Andrew Worster*
Affiliation:
Faculty of Health Sciences, McMaster University, Hamilton, Ont., and the Department of Emergency Medicine, Hamilton Health Sciences and McMaster University, Hamilton, Ont.
*
Department of Emergency Medicine, Hamilton Health Sciences & McMaster University, 237 Barton St. E., Hamilton ON L8N 3Z5; worster@mcmaster.ca

Abstract

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Objective:

Many trauma patients undergo advanced diagnostic imaging before being transferred to a regional trauma centre, but this step can delay definitive care. This study compared the length-of-stay at the primary hospital between patients who underwent CT scans and those who did not.

Methods:

This was a medical record review of all consecutive trauma cases transferred to a regional trauma centre servicing 2.2 million people during a 2-year period. Two trained abstractors, blind to each other's results, collected data independently.

Results:

Of 249 cases, 79 (31%) underwent a CT scan before being transferred. There was no significant difference in the Injury Severity Score between the 2 groups (p = 0.16), yet the CT group remained at the primary hospital approximately 90 minutes longer before transfer (p < 0.001).

Conclusion:

A significant proportion of trauma patients transferred to a regional trauma centre undergo CT scanning at the primary hospital. These patients experience an increased length-of-stay of 90 minutes, on average, before transfer. This appears to be a common practice that does not appear to contribute to definitive trauma management.

Keywords

traumatransfer delaymedical record reviewcomputerized tomographysensitivity analysis
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 10 , Issue 3 , May 2008 , pp. 205 - 208
Copyright
Copyright © Canadian Association of Emergency Physicians 2008

References

1.Ladak, N. National Trauma Registry 2003 Report. Canadian Insitute for Health Information. Toronto (ON); 2003.Google Scholar
2.Cornwell, EE III, Jacobs, D, Walker, M, et al. National Medical Association Surgical Section: position paper on violence prevention: a resolution of trauma surgeons caring for victims of violence. JAMA 1995;273:1788–9.CrossRefGoogle ScholarPubMed
3.Cornwell, EE III, Berne, TV, Blezberg, H, et al. Health care crisis from a trauma center perspective: the L.A. story. JAMA 1996;276:940–4.Google Scholar
4.Meislin, H, Criss, EA, Judkins, D, et al. Fatal rrauma: the modal distribution of time to death is a function of patient demograpxhics and regional resources. J Trauma 1997;43:433–9.CrossRefGoogle Scholar
5.Trunkey, DD. Trauma. Accidental and intentional injuries account for more years of life lost in the U.S. than cancer and heart disease. Among the prescribed remedies are improved preventive efforts, speedier surgery and further research. Sci Am 1983;249:28–35.CrossRefGoogle ScholarPubMed
6.Trunkey, D. Initial management of patients with extensive trauma. N Engl J Med 1991;324:1259–63.Google ScholarPubMed
7.Cowley, RA, Hudson, F, Scanlan, E, et al. An economically proved helicopter program for transporting the emergency critically ill and injured patient in Maryland. J Trauma 1973;13:1029–38.CrossRefGoogle ScholarPubMed
8.Campbell, JE. BTLS. Englewood Cliffs (NJ): Prentice Hall;1998.Google Scholar
9.Creel, JH. Scene size up. In: Campbell, JE, editor. Basic trauma life support: for paramedics and other advanced providers. 4th ed. Upper Saddle River (NJ): Brady; 2000. p. 2–3.Google Scholar
10.Jacobs, LM, Sinclair, A, Beiser, A, et al. Prehospital advanced life support: benefits in trauma. J Trauma 1984;24:8–13.CrossRefGoogle ScholarPubMed
11.Sampalis, JS, Denis, R, Lavoie, A. Trauma care regionalization: a process-outcome evaluation. J Trauma 1999;46:565–79.CrossRefGoogle ScholarPubMed
12.Hedges, JR, Feero, S, Moore, B, et al. Factors contributing to paramedic onscene times during evaluation and management of blunt trauma. Am J Emerg Med 1988;6:443–8.CrossRefGoogle ScholarPubMed
13.Colucciello, SA. Blunt abdominal trauma. Emerg Med Clin North Am 1993;11:114–5.CrossRefGoogle ScholarPubMed
14.Worster, A, Haines, T. Does replacing intravenous pyelography with noncontrast helical computed tomography benefit patients with suspected acute urolithiasis? Can Assoc Radiol J 2002;53:144–8.Google Scholar
15.Worster, A, Haines, T. Advance statistics: medical record review (MRR) studies. Acad Emerg Med 2004;11:187–92.CrossRefGoogle ScholarPubMed
16.Gilbert, EH, Lowenstein, SR, Koziol-McLain, J, et al. Chart reviews in emergency medicine research: Where are the methods? Ann Emerg Med 1996;7:305–8.CrossRefGoogle Scholar