TY  - JOUR
PY  - 2021//
TI  - Incidental findings in the trauma population: interdisciplinary approach and electronic medical record reminder association with pre-discharge reporting and  medicolegal risk
JO  - Journal of the American Academy of Surgeons
A1  - Smith, Lou M.
A1  - King, Sarah A.
A1  - Shealy, Jordan A.
A1  - Heidel, Robert E.
A1  - Morin-Ducote, Garnetta I.
A1  - Husband, Leland D.
A1  - Callison, John C.
A1  - Rosen, Brenton A.
A1  - Savoy, Rachel A.
A1  - Daley, Brian J.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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>
LA  - en
SN  - 1072-7515
UR  - http://dx.doi.org/10.1016/j.jamcollsurg.2020.11.028
ID  - ref1
ER  -