Blunt Trauma and the Role of Routine Pelvic Radiographs

We evaluated clinical factors that are predictive of pelvic X-ray findings. We sought to identify whether routine pelvic films are necessary in blunt trauma and addressed whether removal of these films would minimize cost. We performed a retrospective chart review of 111 patients without pelvic frac...

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Veröffentlicht in:The American surgeon 2001-09, Vol.67 (9), p.849-853
Hauptverfasser: Duane, Therèse M., Cole, Frederic J., Weireter, Leonard J., Britt, L.D.
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Sprache:eng
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Zusammenfassung:We evaluated clinical factors that are predictive of pelvic X-ray findings. We sought to identify whether routine pelvic films are necessary in blunt trauma and addressed whether removal of these films would minimize cost. We performed a retrospective chart review of 111 patients without pelvic fractures and 108 with pelvic fractures seen at our Level 1 trauma center between August 1998 and September 1999. We evaluated initial hemodynamics, physical examination findings, laboratory data, and hospital charges. Patients with fractures had higher Injury Severity Scores (P < 0.001), a higher number of associated injuries (P < 0.001), and lower blood pressures (P < 0.001). The back and pelvic examinations were significantly associated with X-ray results (P < 0.001), and the potential savings with selective radiography was $168,300.00 per year. We believe that clinical factors identified in our study predict the need for pelvic X-ray. Because removal of these films would minimize cost we recommend the elimination of routine pelvic films for the awake and alert blunt trauma patient.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313480106700907