Hidalgo Krisha G, Henken-Siefken Austin, McCague Andrew
College of Medicine, Western University of Health Sciences, Pomona, USA.
Surgery, Desert Regional Medical Center, Palm Springs, USA.
Cureus. 2024 Aug 8;16(8):e66471. doi: 10.7759/cureus.66471. eCollection 2024 Aug.
Introduction Following traumatic injury, patients often require imaging modalities that subject them to large amounts of radiation. The current protocol for imaging workup in trauma patients includes plain radiographs and computed tomography (CT). Although these imaging modalities have improved quality and efficiency in trauma interventions, it is essential to understand their potential limitations and adverse effects. The large amounts of radiation from these imaging tests have raised concern for particularly vulnerable populations, including children and adolescents. Objective To evaluate the trends in radiation exposure in trauma assessment and imaging seen at a Level I trauma center. Methods This retrospective analysis used a de-identified dataset from the trauma registry at Desert Regional Medical Center Level I Trauma Center in Palm Springs, CA. Total radiation amounts were calculated based on the type of diagnostic modality. An effective radiation dose was assigned to each examination (radiograph and CT scan) based on the values provided by the American College of Radiology. Results There was a statistically significant positive correlation between injury severity score and effective radiation dose from imaging workup. From 2016 to 2021, radiation amount and year were found to be negatively correlated. There was a larger, statistically significant amount of radiation dosage among adult trauma patients (16.32 mSv) when compared to pediatric (6.32 mSv) and geriatric (12.67 mSv) groups. Conclusion Our Level I trauma center has observed a decline in radiation exposure with our current trauma protocols in place. On average, adult patients received the highest effective radiation dose to pediatric and geriatric patients. CT scans and radiography are essential tools in initial trauma workup and should be used only in appropriate patients.
引言
创伤后,患者通常需要接受会使其暴露于大量辐射的成像检查。目前创伤患者成像检查的方案包括X线平片和计算机断层扫描(CT)。尽管这些成像检查提高了创伤干预的质量和效率,但了解其潜在局限性和不良影响至关重要。这些成像检查产生的大量辐射引起了对儿童和青少年等特别脆弱人群的关注。
目的
评估一级创伤中心创伤评估和成像中辐射暴露的趋势。
方法
这项回顾性分析使用了加利福尼亚州棕榈泉市沙漠地区医疗中心一级创伤中心创伤登记处的去识别数据集。根据诊断方式的类型计算总辐射量。根据美国放射学会提供的值为每次检查(X线平片和CT扫描)分配有效辐射剂量。
结果
损伤严重程度评分与成像检查的有效辐射剂量之间存在统计学上显著的正相关。2016年至2021年,辐射量与年份呈负相关。与儿科(6.32 mSv)和老年(12.67 mSv)组相比,成年创伤患者的辐射剂量在统计学上显著更高(16.32 mSv)。
结论
我们的一级创伤中心在实施当前创伤方案后观察到辐射暴露有所下降。平均而言,成年患者接受的有效辐射剂量高于儿科和老年患者。CT扫描和X线摄影是初始创伤检查的重要工具,应仅用于合适的患者。