Phoenix Integrated Surgical Residency, Banner Good Samaritan Medical Center, 925 E. McDowell Rd., Second Floor, Phoenix, AZ 85006, USA.
Am J Surg. 2009 Dec;198(6):858-62. doi: 10.1016/j.amjsurg.2009.05.030.
Patients referred to trauma centers often undergo an extensive diagnostic work-up before transfer. The purpose of our study was to quantify and examine the effects of repeat imaging in this population.
A prospective cohort study of 410 patient transfers was performed. Repeat imaging was conducted at the discretion of the accepting surgeon for multiple reasons. Two groups were compared, those who did and those who did not require repeat imaging.
Overall, 53% of referrals received repeat imaging, at an average cost of $2,985 per patient. This group was older (42 vs 37 y; P < .05), more severely injured (injury severity score, 12 vs 9; P < .05), and experienced longer delays before transfer (244 vs 192 min; P < .05). By using logistic regression analysis, injury severity score was found to be an independent predictor of the need for repeat imaging (P = .003).
Severely injured trauma patients often receive films that ultimately require duplication, resulting in transfer delay, unnecessary morbidity, and increased resource use. Targeted education and development of centralized radiology systems could alleviate some of the burden of unnecessary imaging.
送往创伤中心的患者在转院前通常要接受广泛的诊断检查。我们的研究目的是量化并检查这一人群中重复成像的效果。
对 410 例患者的转院进行了前瞻性队列研究。出于多种原因,接受外科医生自行决定是否进行重复成像。比较了两组患者,一组需要重复成像,另一组不需要。
总体而言,53%的转院患者接受了重复成像,每位患者的平均成本为 2985 美元。这组患者年龄更大(42 岁比 37 岁;P <.05),受伤更严重(损伤严重程度评分,12 比 9;P <.05),转院前的延迟时间更长(244 分钟比 192 分钟;P <.05)。通过逻辑回归分析,发现损伤严重程度评分是需要重复成像的独立预测因素(P =.003)。
严重受伤的创伤患者经常接受最终需要重复的片子,导致转院延迟、不必要的发病率和增加资源使用。有针对性的教育和集中放射学系统的发展可以减轻一些不必要成像的负担。