From the Department of Surgery, Wayne State University School of Medicine.
Department of Pediatric Surgery, Children's Hospital of Michigan, Detroit, MI.
Pediatr Emerg Care. 2022 Jan 1;38(1):e431-e435. doi: 10.1097/PEC.0000000000002317.
We hypothesized that imaging is overused in the initial workup of dog bite patients. To reduce radiation exposure, we aim to determine which circumstances surrounding dog bites, patient population, and injury patterns would necessitate imaging studies for management.
A retrospective review was performed on all patients presenting with dog bites to our level I pediatric trauma center between 2013 and 2015. Data collected included: circumstances surrounding the injury, patient demographics, injuries, and imaging studies performed. Our analysis focused on maxillofacial and head CT scans, and plain radiographic studies of the limbs, hands, and feet. Imaging studies were considered positive if there was evidence of bony injury.
We identified 615 patients with dog bites, with 114 patients having had at least one imaging study performed (a total of 145 imaging studies to analyze). Only 13 (11%) patients had a positive study. In the CT scan group, 6 (22.2%) of 27 studies were positive. In the plain radiographic group, 7 (5.9%) of 118 studies were positive.
Our review indicates that imaging studies are overused in the initial workup of these patients, and the majority of these studies are negative. This study confirms that it is feasible to institute guidelines for ordering imaging studies in dog bite patients. This will ultimately reduce radiation exposure and the cost of care for these injuries.
我们假设在犬咬伤患者的初始检查中过度使用了影像学检查。为了减少辐射暴露，我们旨在确定哪些犬咬伤的情况、患者人群和损伤模式需要进行影像学研究以进行管理。
对 2013 年至 2015 年期间在我们的一级儿科创伤中心就诊的所有犬咬伤患者进行了回顾性研究。收集的数据包括：受伤周围的情况、患者人口统计学、损伤和进行的影像学研究。我们的分析重点是颌面和头部 CT 扫描，以及四肢、手部和足部的普通 X 线摄影研究。如果有骨损伤的证据，则认为影像学研究为阳性。
我们确定了 615 名犬咬伤患者，其中 114 名患者至少进行了一次影像学检查（共分析了 145 项影像学检查）。只有 13 名（11%）患者的检查结果为阳性。在 CT 扫描组中，27 项研究中有 6 项（22.2%）为阳性。在普通 X 线摄影组中，118 项研究中有 7 项（5.9%）为阳性。
我们的回顾表明，在这些患者的初始检查中过度使用了影像学检查，而且大多数检查结果为阴性。这项研究证实，为犬咬伤患者制定影像学检查的指导方针是可行的。这最终将减少这些损伤的辐射暴露和治疗成本。
