Prospective evaluation of an evidence-based decision tool to assess pediatric blunt abdominal trauma (BAT)
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Read the article on link.springer.com ↗Article · Jan 2022 · 1 min read
In brief
In brief
Implementation of an evidence-based decision tool for pediatric blunt abdominal trauma reduced CT scan usage from 28% to 21% without missing any injuries. The five-variable protocol was adopted in 85% of cases, demonstrating that selective imaging based on clinical criteria can safely decrease radiation exposure in children.
Written by the GCMD Library team from the article.
Abstract
Purpose
Computed tomography (CT) is currently the standard for evaluation of intra-abdominal injury (IAI) after BAT. Pediatric patients receiving CT scans based on adult clinical protocols are potentially exposed to unnecessary radiation. The purpose of this study is to determine the rate of CT scans before and after implementation of a pediatric BAT decision tool.
Methods
We adapted and implemented an evidence-based decision tool for pediatric BAT based on five clinical variables. We reviewed patient charts 18 months pre- and post-implementation. Demographics and outcomes were compared using Chi-square and Fisher’s exact test, accordingly.
Results
The pre and post-implementation groups were uniform when comparing age, sex, mechanism, and Injury Severity Score. The decision tool was utilized in 85% of patients post-implementation. Fewer CT scans were obtained in the post-implementation group (28 vs. 21%, p = 0.215) with no missed injuries or late diagnoses.
Conclusion
Implementation of a pediatric BAT decision tool decreased CT usage and radiation exposure without an obvious compromise to patient care. This experience supports the utilization of these tools for the assessment of IAI after BAT and have resulted in more selective use of CT during pediatric BAT in our program.