Young Andrew Joseph, Meyers Kenneth Sadler, Wolfe Luke, Duane Therese Marie
Medical College of Virginia, Physicians and Hospitals, Virginia Commonwealth University Health System, Division of Trauma/Critical Care and Emergency Surgery, Richmond, Virginia, USA.
Am Surg. 2012 Jun;78(6):675-8.
Our goal was to determine the characteristics of trauma transfer patients with repeat imaging. A retrospective trauma registry review was performed to evaluate trauma patients who were transferred from referring institutions between January 2005 and December 2009. Patients were divided into those who had a duplicate computed tomography (CT) scan versus those who did not. There were 2678 patients included of whom 559 (21%) had at least one repeat CT scan, whereas 2119 (79%) did not have any repeat CT scans. Those with repeat CT scans were older (42.3 ± 27.3 years vs 37.3 ± 25.6 years), had a higher Injury Severity Score (ISS) (13.7 ± 8.7 vs 11.9 ± 8.8), and more likely to have blunt trauma (odds ratio, 4.7; confidence interval, 2.3 to 9.6) (P for all < 0.0007). Those with CT scans done only at the referring facility were younger, had a lower ISS, and shorter lengths of stay (P for all < 0.0003). ISS and age were independent predictors for repeat CT scans. Transfer patients had imaging repeated one-fifth of the time. The younger, less injured patient went without repeat imaging suggesting that they may have been adequately cared for at the outside institution.
我们的目标是确定接受重复影像学检查的创伤转诊患者的特征。我们进行了一项回顾性创伤登记审查，以评估2005年1月至2009年12月期间从转诊机构转诊的创伤患者。患者被分为进行了重复计算机断层扫描（CT）的患者和未进行重复CT扫描的患者。共有2678例患者纳入研究，其中559例（21%）至少进行了一次重复CT扫描，而2119例（79%）未进行任何重复CT扫描。进行重复CT扫描的患者年龄较大（42.3±27.3岁对37.3±25.6岁），损伤严重度评分（ISS）较高（13.7±8.7对11.9±8.8），且更有可能遭受钝性创伤（比值比，4.7；置信区间，2.3至9.6）（所有P值<0.0007）。仅在转诊机构进行CT扫描的患者年龄较小，ISS较低，住院时间较短（所有P值<0.0003）。ISS和年龄是重复CT扫描的独立预测因素。转诊患者中有五分之一的人进行了重复影像学检查。年龄较小、损伤较轻的患者未进行重复影像学检查，这表明他们可能在外部机构得到了充分的治疗。
