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Emerg Med Australas. 2017 Apr;29(2):192-197. doi: 10.1111/1742-6723.12732.

Computed tomography for head injuries in children: Change in Australian usage rates over time.

Author information

1
Department of Emergency Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
2
Department of Emergency Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
3
Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia.
4
Emergency Department, Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
5
Emergency Department, Canberra Hospital, Canberra, Australian Capital Territory, Australia.
6
Department of Emergency Medicine, Townsville Hospital, Townsville, Queensland, Australia.
7
Paediatric Emergency Department, Monash Medical Centre, Melbourne, Victoria, Australia.
8
Department of Emergency Medicine, Frankston Hospital, Melbourne, Victoria, Australia.
9
Department of Emergency Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia.
10
Department of Emergency Medicine, Sunshine Hospital, Melbourne, Victoria, Australia.
11
Department of Emergency Medicine, Children's Hospital, Sydney, New South Wales, Australia.
12
Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.
13
Middlemore Hospital, Auckland, New Zealand.
14
Department of Emergency Medicine, Kidz First Hospital, Auckland, New Zealand.
15
Department of Medical Imaging, Royal Children's Hospital, Melbourne, Victoria, Australia.
16
Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Abstract

OBJECTIVE:

Paediatric head injury is a common presentation to the ED. North American studies demonstrate increasing use of computed tomography (CT) brain scan (CTB) to investigate head injury. No such data exists for Australian EDs. The aim of this study was to describe CTB use in head injury over time in eight Australian EDs.

METHODS:

Retrospective ED electronic database and medical imaging database audit was undertaken for the years 2001-2010 by International Classification of Diseases (ICD) 9 or 10 code for head injury in children <16 years. EDs and medical imaging departments of eight hospitals in Australia (five tertiary referral and three mixed departments). Data for ED presentations with head injury, and all CTB performed by medical imaging were merged to obtain a data set of CTB performed within 24 h for head injury-related attendances to the ED. Descriptive and comparative analysis of CTB rates was performed.

RESULTS:

The rate of CTB over the decade was 10.2% (95% confidence interval (CI) 9.9-10.5). The annual rate varied from 9.5% (95% CI 8.2-10.9) to 12.5% (95% CI 11.2-13.9). CTB use did not increase over time. Median year of age at time of CT scan was 4 years, with an interquartile range of 1.5-9.4 years. Overall there was a 9.2% increase in the CTB scan rate for every additional year of age at presentation (95% CI 6.6-12.1; P < 0.001).

CONCLUSION:

CTB use in head injuries did not increase during the study period, and rates of CTB were less than reported for North America.

KEYWORDS:

computed tomography scan; head injury; paediatrics; radiation

PMID:
28332331
DOI:
10.1111/1742-6723.12732
[Indexed for MEDLINE]

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