کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6220161 1607448 2014 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Emergency Department Practice Variation in Computed Tomography Use for Children with Minor Blunt Head Trauma
ترجمه فارسی عنوان
اختلال تمرینات گروه اورژانس در استفاده از رایانه تاموگرافی برای کودکان مبتلا به ضایعه نخاعی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پریناتولوژی (پزشکی مادر و جنین)، طب اطفال و بهداشت کودک
چکیده انگلیسی

ObjectiveTo describe factors associated with computed tomography (CT) use for children with minor blunt head trauma that are evaluated in emergency departments.Study designPlanned secondary analysis of a prospective observational study of children <18 years with minor blunt head trauma between 2004 and 2006 at 25 emergency departments. CT scans were obtained at the discretion of treating clinicians. We risk-adjusted patients for clinically important traumatic brain injuries and performed multivariable regression analyses. Outcome measures were rates of CT use by hospital and by clinician training type.ResultsCT rates varied between 19.2% and 69.2% across hospitals. Risk adjustment had little effect on the differential rate of CT use. In low- and middle-risk patients, clinicians obtained CTs more frequently at suburban and nonfreestanding children's hospitals. Physicians with emergency medicine (EM) residency training obtained CTs at greater rates than physicians with pediatric residency or pediatric EM training. In multivariable analyses, compared with pediatric EM-trained physicians, the OR for CT use among EM-trained physicians in children <2 years was 1.24 (95% CI 1.04-1.46), and for children >2 years was 1.68 (95% CI 1.50-1.89). Physicians of all training backgrounds, however, overused CT scans in low-risk children.ConclusionsSubstantial variation exists in the use of CT for children with minor blunt head trauma not explained by patient severity or rates of positive CT scans or clinically important traumatic brain injuries.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Pediatrics - Volume 165, Issue 6, December 2014, Pages 1201-1206.e2
نویسندگان
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