%0 Journal Article
%T Focused Assessment with Sonography in Trauma and Abdominal Computed Tomography Utilization in Adult Trauma Patients: Trends over the Last Decade
%A Alexander Y. Sheng
%A Peregrine Dalziel
%A Andrew S. Liteplo
%A Peter Fagenholz
%A Vicki E. Noble
%J Emergency Medicine International
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/678380
%X Objective. We sought to describe the trend in abdominal CT use in adult trauma patients after a point-of-care emergency ultrasound program was introduced. We hypothesized that abdominal CT use would decrease as FAST use increased. Methods. We performed a retrospective study of 19940 consecutive trauma patients over the age of 18 admitted to our level one trauma center from 2002 through 2011. Data was collected retrospectively and recorded in a trauma registry. We plotted the rate of FAST and abdominal CT utilization over time. Head CT was used as a surrogate for overall CT utilization rates during the study period. Results. Use of FAST increased by an average of 2.3% (95% CI 2.1 to 2.5, ) while abdominal CT use decreased by the same rate annually. The percentage of patients who received FAST as the sole imaging modality for the abdomen rose from 2.0% to 21.9% while those who only received an abdominal CT dropped from 21.7% to 2.3%. Conclusions. Abdominal CT use in our cohort declined while FAST utilization grew in the last decade. The rising use of FAST may have played a role in the reduction of abdominal CT performed as decline in CT utilization appears contrary to overall trends. 1. Introduction There has been a doubling of patient exposure to ionizing radiation in the last two decades in the United States. This increase is largely attributed to an explosive rise in the use of computed tomography (CT) [1]. Approximately, more than 62 million CT scans are currently obtained annually in the United States, compared to 3 million in 1980 [2]. Specifically, 18.3 million abdominal CT¡¯s are performed in the United States in 2007 [3]. Thus, in addition to increasing concerns about the rising cost of diagnostic imaging, there is growing and justifiable concern regarding health risks of radiation exposure [2¨C6]. Despite a frequently favorable benefit-to-risk ratio for the use of CT in symptomatic patients, increasing literature suggests an overuse of CT and questions its yield in specific contexts, including the evaluation of blunt trauma [7¨C12]. While much critique is based on pediatric data, the highest public health impact of reducing CT use may be in adults, specifically in reducing chest and abdominal scans in adult trauma patients aged 35¨C54 [3]. Thus, the Food and Drug Administration has recently proposed a national initiative to reduce radiation exposure from unnecessary imaging [13]. Concomitantly, the use of ultrasound in emergency medicine has blossomed [14¨C18]. Benefits of emergency bedside ultrasound include lack of radiation exposure, ability to
%U http://www.hindawi.com/journals/emi/2013/678380/