CT scans may be overused in white children with low risk head injuries, which could result in increased radiation exposure and health care costs
BOSTON – African-American and Hispanic children are less likely to receive a cranial computed tomography (CT) scan in an emergency department following minor head trauma than white children, according to University of Michigan research presented Oct. 14 at the American Academy of Pediatrics National Conference and Exhibition in Boston.
While racial disparities in adult health care are well documented, less is known about the variations in pediatric, and specifically, Emergency Department care. Appropriate CT scan use can ensure optimal diagnosis. However, as CT scans emit "appreciable radiation," potentially increasing cancer risk, their overuse can be harmful and expensive.
In the study, "Cranial CT Use for Minor Head Trauma in Children is Associated with Race/Ethnicity," researchers at the University of Michigan and other institutions including University of California-Davis, reviewed existing data on children seeking care at one of 25 Pediatric Emergency Care Applied Research Network trauma centers. The study looked at CT use following a head injury, based on the child's potential for traumatic brain injury.
Of the 42,412 children enrolled in the main study, all of whom were evaluated for head trauma, 39,717 (94 percent) had a documented race/ethnicity of Hispanic, African-American or white.
Of these, 13, 793 children (35 percent) were imaged with a CT. While there was no significant difference by race/ethnicity in the likelihood that a child deemed at higher risk for a traumatic brain injury would receive a CT scan, white children at the lowest risk were significantly more likely to receive a CT scan.
"Our study demonstrates that among children with minor head trauma, but at low risk for clinically important brain injury, white children received cranial CT scans more frequently than black or Hispanic children," says Alexander Rogers, M.D., F.A.A.P., assistant professor of emergency medicine at the University of Michigan Health System. "In this low-risk population, higher rates of cranial CT may represent overuse in white children, leading to increased radiation exposure and health care costs."
"The cause of this disparity is likely multi-factorial, but this study highlights the importance of strong, evidence-based guidelines to assure equal and optimal care," Rogers adds.
The University of Michigan C.S. Mott Children’s Hospital is consistently ranked as one of the best hospitals in the country. It was nationally ranked in all ten pediatric specialties in the U.S. News Media Group’s 2011 edition of "America’s Best Children’s Hospitals" including third in the country for heart and heart surgery. In November, the hospital moves to a new 1.1 million square feet, $754 million state-of-the-art facility that will be home to cutting-edge specialty services for newborns, children and women.
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and wellbeing of infants, children, adolescents and young adults. For more information, visit http://www.aap.org.
By the American Academy of Pediatrics