{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T04:04:19Z","timestamp":1746417859531,"version":"3.40.4"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2024,11]]},"abstract":"\n Objectives<\/jats:title>\n Over the past decade, there has been a significant effort to decrease radiation exposure in pediatric trauma patients. The objective of this study was to determine if trauma centers (TCs) and nontrauma centers (non-TCs) are practicing in line with this effort. We hypothesized that TCs would demonstrate a significant decrease in the use of chest computed tomography (CT) during the study period, whereas non-TC would show no change in chest CT use.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We queried a state-wide database from 2010 to 2020 for pediatric trauma encounters at TCs and non-TCs within a single large health system. All transfer encounters were excluded. Chest CTs and chest radiographs (CXRs) were performed, and injury diagnosis codes were extracted for each encounter. Chest CT use and incidence of thoracic injuries were compared between TCs and non-TCs.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 13,014 encounters were included, of which 85.8% occurred at TCs and 14.2% occurred at non-TCs. There were significant differences between TC and non-TC encounter demographics. During the study period, the percentage of trauma encounters in which chest CT was obtained increased yearly at both TCs and non-TCs. Among encounters where both modalities were performed in the first 24 hours, chest CT was performed before CXR in 0.4% of TC and 0.1% of non-TC encounters (P<\/jats:italic> = 0.086). Among encounters without thoracic injury, chest CT was performed in 5.2% of cases at non-TCs and 4.5% of cases at TCs (P<\/jats:italic> < 0.001).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In the trauma encounters studied, chest CT was performed prior to CXR more frequently at TCs compared to non-TCs. These data may reflect regional trauma triage protocols, availability of chest CT, or differences in education between institutions. Whereas TCs may see more severely injured patients more frequently, education regarding conservative CT imaging principles should be reinforced through multidisciplinary efforts.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/pec.0000000000003250","type":"journal-article","created":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T03:08:42Z","timestamp":1724382522000},"page":"781-785","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Are We Imaging Gently in Indiana? A System-Wide Population-Based Study of Chest CT Use in the Pediatric Trauma Population"],"prefix":"10.1097","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6418-8351","authenticated-orcid":false,"given":"Sindhu","family":"Mannava","sequence":"first","affiliation":[{"name":"Department of Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amelia","family":"Collings","sequence":"additional","affiliation":[{"name":"Department of Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cameron","family":"Colgate","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research in Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lava","family":"Timsina","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research in Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Landman","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery Indiana University School of Medicine, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2024,8,23]]},"reference":[{"issue":"11 Suppl","key":"bib1-20250504","first-page":"S409","article-title":"Pediatric thoracic trauma","volume":"30","year":"2002","journal-title":"Crit Care Med"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1097\/SLA.0000000000000259","article-title":"Improving ATLS performance in simulated pediatric trauma resuscitation using a checklist","volume":"259","year":"2014","journal-title":"Ann Surg"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1016\/j.amjsurg.2020.06.043","article-title":"Review, monitor, educate: a quality improvement initiative for sustained chest radiation reduction in pediatric trauma patients","volume":"220","year":"2020","journal-title":"Am J Surg"},{"key":"bib4-20250504","first-page":"118","article-title":"Radiation dose in paediatric computed tomography: risks and benefits","volume":"8","year":"2010","journal-title":"Ann Ib Postgrad Med"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1258\/jrsm.2011.110180","article-title":"The answer is 17 years, what is the question: understanding time lags in translational research","volume":"104","year":"2011","journal-title":"J R Soc Med"},{"issue":"Suppl 2","key":"bib6-20250504","first-page":"783","article-title":"What can implementation science do for you? Key success stories from the field","volume":"35","year":"2020","journal-title":"J Gen Intern Med"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1016\/j.jpedsurg.2020.01.006","article-title":"Utilization of CT imaging in minor pediatric head, thoracic, and abdominal trauma in the United States","volume":"55","year":"2020","journal-title":"J Pediatr Surg"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1016\/j.jpedsurg.2007.02.007","article-title":"Peer assessment of pediatric surgeons for potential risks of radiation exposure from computed tomography scans","volume":"42","year":"2007","journal-title":"J Pediatr Surg"},{"key":"bib9-20250504","first-page":"23","article-title":"The utility of computed tomography as a screening tool for the evaluation of pediatric blunt chest trauma","volume":"67","year":"2009","journal-title":"J Trauma"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1097\/TA.0000000000001110","article-title":"Limiting chest computed tomography in the evaluation of pediatric thoracic trauma","volume":"81","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"key":"bib11-20250504","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.jpedsurg.2022.09.027","article-title":"Sustaining the gains: reducing unnecessary computed tomography scans in pediatric trauma patients","volume":"58","year":"2023","journal-title":"J Pediatr Surg"},{"key":"bib12-20250504","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1097\/TA.0000000000001974","article-title":"Implementation of a CT scan practice guideline for pediatric trauma patients reduces unnecessary scans without impacting outcomes","volume":"85","year":"2018","journal-title":"J Trauma Acute Care Surg"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000003250","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:03:07Z","timestamp":1746381787000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000003250"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,23]]},"references-count":12,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000003250","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"type":"electronic","value":"1535-1815"},{"type":"print","value":"0749-5161"}],"subject":[],"published":{"date-parts":[[2024,8,23]]}}}