儿童头部损伤的计算机断层扫描：澳大利亚使用率随时间的变化。

Computed tomography for head injuries in children: Change in Australian usage rates over time.

作者信息

Oakley Ed, May Rachel, Hoeppner Tobias, Sinn Kam, Furyk Jeremy, Craig Simon, Rosengarten Pamela, Kochar Amit, Krieser David, Dalton Sarah, Dalziel Stuart, Neutze Jocelyn, Cain Tim, Jachno Kim, Babl Franz E

机构信息

Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.

Department of Emergency Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

出版信息

Emerg Med Australas. 2017 Apr;29(2):192-197. doi: 10.1111/1742-6723.12732.

DOI:10.1111/1742-6723.12732

PMID:28332331

Abstract

OBJECTIVE

Paediatric head injury is a common presentation to the ED. North American studies demonstrate increasing use of computed tomography (CT) brain scan (CTB) to investigate head injury. No such data exists for Australian EDs. The aim of this study was to describe CTB use in head injury over time in eight Australian EDs.

METHODS

Retrospective ED electronic database and medical imaging database audit was undertaken for the years 2001-2010 by International Classification of Diseases (ICD) 9 or 10 code for head injury in children <16 years. EDs and medical imaging departments of eight hospitals in Australia (five tertiary referral and three mixed departments). Data for ED presentations with head injury, and all CTB performed by medical imaging were merged to obtain a data set of CTB performed within 24 h for head injury-related attendances to the ED. Descriptive and comparative analysis of CTB rates was performed.

RESULTS

The rate of CTB over the decade was 10.2% (95% confidence interval (CI) 9.9-10.5). The annual rate varied from 9.5% (95% CI 8.2-10.9) to 12.5% (95% CI 11.2-13.9). CTB use did not increase over time. Median year of age at time of CT scan was 4 years, with an interquartile range of 1.5-9.4 years. Overall there was a 9.2% increase in the CTB scan rate for every additional year of age at presentation (95% CI 6.6-12.1; P < 0.001).

CONCLUSION

CTB use in head injuries did not increase during the study period, and rates of CTB were less than reported for North America.

摘要

目的

儿科头部损伤是急诊科常见的就诊情况。北美研究表明，越来越多地使用计算机断层扫描（CT）脑部扫描（CTB）来调查头部损伤。澳大利亚急诊科尚无此类数据。本研究的目的是描述澳大利亚8家急诊科随时间推移在头部损伤中使用CTB的情况。

方法

通过国际疾病分类（ICD）9或10编码，对2001年至2010年16岁以下儿童头部损伤进行回顾性急诊科电子数据库和医学影像数据库审核。澳大利亚8家医院的急诊科和医学影像科（5家三级转诊医院和3家综合科室）。将头部损伤的急诊科就诊数据与医学影像科进行的所有CTB数据合并，以获得因头部损伤相关就诊而在24小时内进行的CTB数据集。对CTB使用率进行描述性和比较性分析。

结果

十年间CTB使用率为10.2%（95%置信区间（CI）9.9 - 10.5）。年使用率从9.5%（95%CI 8.2 - 10.9）到12.5%（95%CI 11.2 - 13.9）不等。CTB的使用并未随时间增加。CT扫描时的年龄中位数为4岁，四分位间距为1.5 - 9.4岁。总体而言，就诊时每增加一岁，CTB扫描率增加9.2%（95%CI 6.6 - 12.1；P < 0.001）。