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{
    "pk": 11568,
    "title": "Blunt Trauma Abdominal and Pelvic Computed Tomography Has Low Yield for Injuries in More Than One Anatomic Region",
    "subtitle": null,
    "abstract": "Introduction:\n Most trauma centers order abdominal and pelvic computed tomography (CT) as an automatically paired CT for adult blunt trauma evaluation. However, excessive CT utilization adds risks of excessive exposure to ionizing radiation, the need to work up incidental findings (leading to unnecessary and invasive tests), and greater costs. Examining a cohort of adult blunt trauma patients that received paired abdominal and pelvic (A/P) CT, we sought to determine the diagnostic yield of clinically significant injuries (CSI) in the following: 1) the abdomen alone; 2) the pelvis alone; 3) the lumbosacral spine alone; and 4) more than one of these anatomic regions concomitantly.\n \nMethods:\n In this retrospective study, we reviewed the imaging and hospital course of a consecutive sample of blunt trauma activation patients older than 14 years of age who received paired A/PCT during their blunt trauma assessments at an urban Level I trauma center from April through October 2014. Categorization of CSI was determined according to an a priori, expert panel-derivedclassification scheme.\nResults:\n The median age of the 689 patients who had A/P CT was 48 years old; 68.1% were male; 64.0% were admitted, and hospital mortality was 3.6%. CSI yields were as follows: abdomen 2.2% (95% confidence interval [CI] [1.3-3.6%]); pelvis 2.9% (95% CI [1.9-4.4%]); lumbosacral spine 0.6% (95% CI [0.2-1.5%]); both abdomen and pelvis 0.3% (95% CI [0.1-1.1%]); both the abdomen andlumbosacral spine 0.6% (0.2-1.5%); both the pelvis and lumbosacral spine 0.1% (0.0-0.8%); all three regions – abdomen, pelvis and lumbosacral spine – 0.1% (0.0-0.8%).\nConclusion:\n Automatic pairing of A/P CT has very low diagnostic yield for CSI in both the abdomenand pelvis. These data suggest a role for selective CT imaging protocols that image these regions individually instead of automatically as a pair.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Abdominal CT"
        },
        {
            "word": "Pelvic CT"
        },
        {
            "word": "blunt trauma"
        },
        {
            "word": "Selective Imaging"
        },
        {
            "word": "Yields of CT"
        }
    ],
    "section": "Trauma",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/3m72b0gk",
    "frozenauthors": [
        {
            "first_name": "Robert",
            "middle_name": "M.",
            "last_name": "Rodriguez",
            "name_suffix": "",
            "institution": "University of California, San Francisco, Department of Emergency Medicine, San Francisco, California",
            "department": "None"
        },
        {
            "first_name": "Noah",
            "middle_name": "",
            "last_name": "Hawthorne",
            "name_suffix": "",
            "institution": "University of California, San Francisco, Department of Emergency Medicine, San Francisco, California",
            "department": "None"
        },
        {
            "first_name": "David",
            "middle_name": "",
            "last_name": "Haase",
            "name_suffix": "",
            "institution": "University of California, San Francisco, Department of Emergency Medicine, San Francisco, California",
            "department": "None"
        },
        {
            "first_name": "Shelby",
            "middle_name": "P.",
            "last_name": "Murphy",
            "name_suffix": "",
            "institution": "University of California, San Francisco, Department of Emergency Medicine, San Francisco, California",
            "department": "None"
        },
        {
            "first_name": "Chika",
            "middle_name": "",
            "last_name": "Chuku",
            "name_suffix": "",
            "institution": "University of California, San Francisco, Department of Emergency Medicine, San Francisco, California",
            "department": "None"
        },
        {
            "first_name": "Jason",
            "middle_name": "",
            "last_name": "Wen",
            "name_suffix": "",
            "institution": "University of California, San Francisco, Department of Emergency Medicine, San Francisco, California",
            "department": "None"
        }
    ],
    "date_submitted": "2018-01-17T15:23:41-08:00",
    "date_accepted": "2018-01-17T15:23:41-08:00",
    "date_published": "2018-07-26T13:40:02-07:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/11568/galley/6233/download/"
        }
    ]
}