@article{ref1,
title="Trauma center variation of head computed tomography utilization in children presenting with mild traumatic brain injury",
journal="Clinical imaging",
year="2022",
author="Gerber, Noam and Munnangi, Swapna and Vengalasetti, Yasaswi and Gupta, Sameer",
volume="94",
number="",
pages="125-131",
abstract="BACKGROUND: Although published clinical decision rules have identified indications for the use of head CT in children with mild traumatic brain injury, practices vary. <br><br>OBJECTIVE: This study seeks to evaluate whether the utilization of head CT in pediatric trauma patients presenting with mTBI varies between American College of Surgeons verified pediatric trauma centers (ACS-PTC) and adult-only trauma centers (ACS-AOTC). MATERIAL AND METHODS: A retrospective cohort study of 24,104 trauma patients, ≤17, who presented to the emergency department at 337 ACS verified level I/II trauma centers with isolated mTBI was conducted using National Trauma Data Bank records (2011-2015). Multivariable logistic regression was used to compare the odds of a patient receiving a head CT when treated at an ACS-PTC vs. an ACS-AOTC, controlling for demographic, injury, and hospital-level confounders. Effect modification by loss of consciousness was assessed and adjusted head CT odds were recalculated in patients stratified by LOC status. <br><br>RESULTS: There was no significant difference in the adjusted odds of receiving a head CT at an ACS-PTC vs. an ACS-AOTC (odds ratio: 0.98, 95% confidence interval: 0.92-1.04). However, in patients who had a LOC, the adjusted OR of receiving a head CT at an ACS-PTC vs ACS-AOTC was 0.71 (95% confidence interval: 0.65-0.78). <br><br>CONCLUSION: Children presenting to the emergency department of an ACS-verified level I or II trauma center with mTBI who had a loss of consciousness are less likely to receive a head CT at an ACS verified pediatric trauma center than at an ACS verified adult-only trauma center.<p /> <p>Language: en</p>",
language="en",
issn="0899-7071",
doi="10.1016/j.clinimag.2022.11.024",
url="http://dx.doi.org/10.1016/j.clinimag.2022.11.024"
}