Most incidental findings on trauma CT go uncaptured
As emergency CT has grown in use, incidental findings in trauma patients have multiplied. No surprise there, but a study conducted at a level-1 trauma center in New York City suggests that documentation of incidental findings may be seriously lacking, with obvious potential implications for follow-up care.
Melissa James, PhD, and colleagues at Jamaica Hospital Medical Center in Queens retrospectively reviewed 1,573 CT images acquired from 416 patients during trauma assessment while prospectively documenting incidental findings over a six-month period.
Analyzing the frequency of incidental findings and follow-up referrals, they found that 478 of the scans (30.4 percent) revealed 858 incidental findings—average, three per patient—yet only 12 such findings, 1.4 percent, were documented in a discharge note.
They also found the abdomen/pelvis had the highest rate of incidental findings (61.7 percent), follow-up was required for 24 incidental findings (2.8 percent), and admission/immediate intervention was required for six findings (0.7 percent).
Meanwhile, using logistic regression to identify independent risk factors, the researchers found that increasing age, a higher body mass index and receiving a pan (whole-body) CT increased the odds of having an incidental finding (p < 0.001, p = 0.015 and p < 0.001, respectively).
“A large percentage of trauma patients have incidental findings,” James and colleagues conclude. “Therefore, better documentation and follow-up are needed to determine the long-term outcomes of patients with clinically relevant incidental findings.”
The study is running in the August edition of Emergency Radiology.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.