Pretransfer computed tomography delays arrival to definitive care without affecting pediatric trauma outcomes.

PURPOSE: Children with thoracic or abdominal trauma, presenting to referring hospitals, may undergo CT imaging prior to transfer to a pediatric trauma center (PTC). We sought to determine if children who undergo pretransfer imaging experience a delay in definitive care and worse clinical outcomes. METHODS: Pediatric blunt trauma patients transferred to our level I PTC were identified in this IRB approved study. Those transferred with CT imaging of the chest or abdomen/pelvis prior to transfer were compared to those transferred without imaging. RESULTS: Of 246 patients with a mean age of 12.4±5.3years (64% male), 128 patients (52%) underwent chest (n=85) and/or abdominal (n=115) CT studies prior to transfer. Among those patients with pretransfer CT, 14% of CT scans were repeated. On multivariate analysis accounting for distance, time from injury to arrival at our PTC was significantly greater in children who underwent pretransfer CT (320±216 vs. 208±149minutes, p<0.001). Median length of stay (3 vs. 3days) and mortality (3% vs. 3%) were similar between groups (all p>0.05). CONCLUSIONS: A substantial number of pediatric blunt trauma patients underwent CT scans prior to transfer, which is associated with a delay in transfer but not worse outcomes.

Duke Scholars

Author Ryan M Antiel Surgery, Pediatric General Surgery