Falls, older adults, and the trend in utilization of CT in a level I trauma center

Bahman Sayyar Roudsari, Kevin J. Psoter, Gabriel C. Fine, Jeffrey G. Jarvik

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

OBJECTIVE. The purpose of this article is to evaluate the trend in the utilization of CT for fall victims older than 55 years admitted to a level I trauma center. MATERIALS AND METHODS. We used trauma registry data (1996-2006) of a level I trauma center. By using the International Classification of Disease, Ninth Revision (Clinical Modification) codes, we identified the type and frequency of CT examinations for each patient. We used negative binomial regression to evaluate the association between CT utilization rates and age, year of admission, sex, insurance status, ethnicity, ICU admission status, injury severity score, and final disposition (i.e., deceased vs alive). We used logistic regression to evaluate predictors of repeat (i.e., ≥ 2) CT scans. RESULTS. During the study period, the utilization rate of head, abdomen, thorax, and other body region (including spine and extremities) CT examinations increased, on average, by 7%, 16%, 14%, and 15% per year, respectively. Older age was associated with a higher utilization of head CT. Male sex and ICU admission were associated with higher utilization for all types of CT examinations. Repeat head and abdominal CT scans increased, on average, by 28% (95% CI, 20-36%) and 24% (95% CI, 2-51%) per year, respectively. CONCLUSION. We quantified the increase in utilization rates of all types of CT scans for fall victims admitted to a level I trauma center. We found a marked increase in CT use over time, both for initial as well as repeat studies, and an association between CT use and variables such as sex. Future studies should focus on the evaluation of CT appropriateness and their influence on patient outcomes.

Original languageEnglish (US)
Pages (from-to)985-991
Number of pages7
JournalAmerican Journal of Roentgenology
Volume198
Issue number5
DOIs
StatePublished - May 1 2012
Externally publishedYes

Keywords

  • CT
  • Level I trauma center
  • Older adults
  • Trend analysis
  • Utilization rates

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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