@article{ref1,
title="Incidental findings in the trauma population: interdisciplinary approach and electronic medical record reminder association with pre-discharge reporting and  medicolegal risk",
journal="Journal of the American Academy of Surgeons",
year="2021",
author="Smith, Lou M. and King, Sarah A. and Shealy, Jordan A. and Heidel, Robert E. and Morin-Ducote, Garnetta I. and Husband, Leland D. and Callison, John C. and Rosen, Brenton A. and Savoy, Rachel A. and Daley, Brian J.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Incidental findings (IF) are reported in 20% or more of trauma CT scans. In addition to the importance of patient disclosure, there is significant legal  pressure to avoid missed diagnoses. We reported previously 63.5% of IF were  disclosed prior to discharge, with 20% non-disclosed. We initiated a  multi-disciplinary systemic plan to effect pre-discharge disclosure by synoptic CT  reports with American College of Radiology (ACR) recommended follow-up, EMR  discharge prompts, and provider education. STUDY DESIGN: Prospective observational  series patients from November 2019-February 2020. Statistical analysis performed  with SPSS statistical package web version 21. <br><br>RESULTS: 877 patients (pts) with CT  (507 males/370 females) Average age was 57 years (range: 14-99) and 96% had blunt  injury. In 315 pts there were 523 IF (1.7 per pt.), the most common being lung  (17.5%), kidney (13%) and liver (11%). Radiology report compliance was 210 of 249  (84%). There were 66 studies from outside facilities. Sixteen IF were suspicious for  malignancy. A total of 151 pts needed no follow-up and 148 pts needed future  follow-up evaluation. Pre-discharge IF disclosure compliance was 90.1% (286  patients), with 25 post-discharge. Four pts remain undisclosed. Compared to our  previous report, clearer reporting and EMR prompts increased pre-discharge  disclosure from 63.5% to 90.1% (p < 0.01, Chi-square test) and decreased days to  notification from 29.5 (0-277) to 5.2 (range 0-59) (p < 0.01, Mann-Whitney U test.)  CONCLUSION: Timely, complete disclosure of IF improves patient outcome and reduces  medicolegal risk. Collaboration between trauma, radiology, and IT promotes improved  disclosure in trauma populations.<p /> <p>Language: en</p>",
language="en",
issn="1072-7515",
doi="10.1016/j.jamcollsurg.2020.11.028",
url="http://dx.doi.org/10.1016/j.jamcollsurg.2020.11.028"
}