Quantitative Assessment of Radiation Doses from Computed Tomography of Patients in the Emergency Department Following Trauma Team Activation

Song, Ju Hyun; Kim, Soo Hyun; Jung, Seung Eun; Oh, Sang Hoon; Jeong, Won Jung; Kim, Han Joon; Park, Kyu Nam

Abstract

PURPOSE
Emergency physicians utilize multiple computed tomography (CT) scans in acute evaluation of patients with multiple traumas. By its nature, CT involves larger radiation doses than conventional X-ray films do. A significant association was reported between radiation dose and increasing risk of cancer in atomic bomb survivors and radiation workers. The object of this study was to investigate the amount (dose) of CT radiation in patients who activated the trauma team during the first 24 hours of their stay in the emergency department.
METHODS
This study was designed as a retrospective analysis of radiologic and medical data. We reviewed 39 trauma patients who activated the trauma team of our emergency department between January 2008 and April 2009. Individual radiation dose reports calculated by the CT scanner were used to determine radiation dose from each CT scan. Radiation doses calculated by CT scanners were converted to effective dose by multiplying by a conversion coefficient.
RESULTS
A total of 33 patients were enrolled. Among these patients, 24(72.7%) were male. The mean age was 41.88+/-16.13 years. The mean Revised Trauma Score was 6.94+/-1.16. The mean Injury severity score was 22.85+/-10.34. The mean number of total CT scans was 3.61+/-1.22. The median effective dose of the total CT scans was 68.81 mSv, with an intraquartile range of 56.30 to 88.41 mSv.
CONCLUSION
Trauma patients in the emergency department following trauma team activation are exposed to clinically significant radiation doses from CT imaging during the first 24 hours of their stay.