Pretransfer computed tomography delays arrival to definitive care without affecting pediatric trauma outcomes

J Pediatr Surg. 2016 Feb;51(2):323-5. doi: 10.1016/j.jpedsurg.2015.10.055. Epub 2015 Oct 31.


Purpose: Children with thoracic or abdominal trauma, presenting to referring hospitals, may undergo CT imaging prior to transfer to a pediatric trauma center (PTC). We sought to determine if children who undergo pretransfer imaging experience a delay in definitive care and worse clinical outcomes.

Methods: Pediatric blunt trauma patients transferred to our level I PTC were identified in this IRB approved study. Those transferred with CT imaging of the chest or abdomen/pelvis prior to transfer were compared to those transferred without imaging.

Results: Of 246 patients with a mean age of 12.4±5.3years (64% male), 128 patients (52%) underwent chest (n=85) and/or abdominal (n=115) CT studies prior to transfer. Among those patients with pretransfer CT, 14% of CT scans were repeated. On multivariate analysis accounting for distance, time from injury to arrival at our PTC was significantly greater in children who underwent pretransfer CT (320±216 vs. 208±149minutes, p<0.001). Median length of stay (3 vs. 3days) and mortality (3% vs. 3%) were similar between groups (all p>0.05).

Conclusions: A substantial number of pediatric blunt trauma patients underwent CT scans prior to transfer, which is associated with a delay in transfer but not worse outcomes.

Keywords: Computer tomography; Injury; Pediatric trauma; Transfer.

Publication types

  • Observational Study

MeSH terms

  • Abdominal Injuries / diagnostic imaging*
  • Abdominal Injuries / mortality
  • Adolescent
  • Child
  • Female
  • Humans
  • Length of Stay
  • Male
  • Patient Transfer*
  • Referral and Consultation
  • Retrospective Studies
  • Thoracic Injuries / diagnostic imaging*
  • Thoracic Injuries / mortality
  • Time Factors
  • Tomography, X-Ray Computed*
  • Trauma Centers
  • Wounds, Nonpenetrating / diagnostic imaging*
  • Wounds, Nonpenetrating / mortality