Assessment of Cost-Effectiveness of Computerized Cranial Tomography in Children with Mild Head Trauma
Purpose: Pediatric head traumas constitute the majority of admissions to emergency departments (ED) due to trauma. This study aims to draw attention to the use of cranial computerized tomography (CT) scans in the evaluation of children with head trauma under the age of 18, and to determine CT scans’...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/11/2649 |
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| author | Mustafa Çalik Ayşe Hilal Ersoy Elif Evrim Ekin Derya Öztürk Seda Geylani Güleç |
| author_facet | Mustafa Çalik Ayşe Hilal Ersoy Elif Evrim Ekin Derya Öztürk Seda Geylani Güleç |
| author_sort | Mustafa Çalik |
| collection | DOAJ |
| description | Purpose: Pediatric head traumas constitute the majority of admissions to emergency departments (ED) due to trauma. This study aims to draw attention to the use of cranial computerized tomography (CT) scans in the evaluation of children with head trauma under the age of 18, and to determine CT scans’ usefulness in terms of cost-effectiveness. Materials and Methods: Age, gender, mechanism of trauma and Glasgow Coma Scale (GCS), diagnosis, time of admission to hospital, hospitalization and operation, cranial computerized tomography and hospitalization costs of all cases were retrospectively analyzed. Results: A total of 26,412 patients younger than 18 years old who were admitted to the emergency department due to head trauma and who had a cranial tomography were analyzed. They had a mean age of 7.74 ± 5.66 years. In total, 26,363 (99.8%) of these patients had a GCS greater than 14. Out of these patients, only 402 (1.5%) had brain injury revealed by cranial CT, 41 (0.2%) of these patients were operated and 3 of the patients lost their lives. The total cost of patients admitted to the emergency department with a head injury amounts to USD 583,317. Furthermore, 75.78% of this cost comes from negative cranial CTs. A cost analysis according to different age groups did not show a meaningful difference between 0–2 years and 3–5 years (<i>p</i> = 1.000), but there was a meaningful difference for all the other age groups. Conclusion: Our findings show that applying algorithms to predict traumatic brain injury in children with mild head injury rather than scanning all patients with cranial CT will enable more reliable and cost-effective patient care. Current practices should be reviewed to avoid unnecessary radiation exposure and expense in the ED. It is also necessary to inform and educate parents about the risk/benefit ratio of cranial CT scans. |
| first_indexed | 2024-03-09T19:09:12Z |
| format | Article |
| id | doaj.art-39058efbaffb446c8b3a1a0791f880e6 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T19:09:12Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-39058efbaffb446c8b3a1a0791f880e62023-11-24T04:18:43ZengMDPI AGDiagnostics2075-44182022-10-011211264910.3390/diagnostics12112649Assessment of Cost-Effectiveness of Computerized Cranial Tomography in Children with Mild Head TraumaMustafa Çalik0Ayşe Hilal Ersoy1Elif Evrim Ekin2Derya Öztürk3Seda Geylani Güleç4Department of Emergency Medicine, University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, 34245 Istanbul, TurkeyDepartment of Emergency Medicine, University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, 34245 Istanbul, TurkeyDepartment of Radiology, University of Health Sciences, Gaziosmanpasa Training and Research Hospital, 34245 Istanbul, TurkeyDepartment of Emergency Medicine, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, 34371 Istanbul, TurkeyDepartment of Pediatry, University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, 34245 Istanbul, TurkeyPurpose: Pediatric head traumas constitute the majority of admissions to emergency departments (ED) due to trauma. This study aims to draw attention to the use of cranial computerized tomography (CT) scans in the evaluation of children with head trauma under the age of 18, and to determine CT scans’ usefulness in terms of cost-effectiveness. Materials and Methods: Age, gender, mechanism of trauma and Glasgow Coma Scale (GCS), diagnosis, time of admission to hospital, hospitalization and operation, cranial computerized tomography and hospitalization costs of all cases were retrospectively analyzed. Results: A total of 26,412 patients younger than 18 years old who were admitted to the emergency department due to head trauma and who had a cranial tomography were analyzed. They had a mean age of 7.74 ± 5.66 years. In total, 26,363 (99.8%) of these patients had a GCS greater than 14. Out of these patients, only 402 (1.5%) had brain injury revealed by cranial CT, 41 (0.2%) of these patients were operated and 3 of the patients lost their lives. The total cost of patients admitted to the emergency department with a head injury amounts to USD 583,317. Furthermore, 75.78% of this cost comes from negative cranial CTs. A cost analysis according to different age groups did not show a meaningful difference between 0–2 years and 3–5 years (<i>p</i> = 1.000), but there was a meaningful difference for all the other age groups. Conclusion: Our findings show that applying algorithms to predict traumatic brain injury in children with mild head injury rather than scanning all patients with cranial CT will enable more reliable and cost-effective patient care. Current practices should be reviewed to avoid unnecessary radiation exposure and expense in the ED. It is also necessary to inform and educate parents about the risk/benefit ratio of cranial CT scans.https://www.mdpi.com/2075-4418/12/11/2649cranial CTcost-effectivenesshead traumasmalignancypediatric |
| spellingShingle | Mustafa Çalik Ayşe Hilal Ersoy Elif Evrim Ekin Derya Öztürk Seda Geylani Güleç Assessment of Cost-Effectiveness of Computerized Cranial Tomography in Children with Mild Head Trauma Diagnostics cranial CT cost-effectiveness head traumas malignancy pediatric |
| title | Assessment of Cost-Effectiveness of Computerized Cranial Tomography in Children with Mild Head Trauma |
| title_full | Assessment of Cost-Effectiveness of Computerized Cranial Tomography in Children with Mild Head Trauma |
| title_fullStr | Assessment of Cost-Effectiveness of Computerized Cranial Tomography in Children with Mild Head Trauma |
| title_full_unstemmed | Assessment of Cost-Effectiveness of Computerized Cranial Tomography in Children with Mild Head Trauma |
| title_short | Assessment of Cost-Effectiveness of Computerized Cranial Tomography in Children with Mild Head Trauma |
| title_sort | assessment of cost effectiveness of computerized cranial tomography in children with mild head trauma |
| topic | cranial CT cost-effectiveness head traumas malignancy pediatric |
| url | https://www.mdpi.com/2075-4418/12/11/2649 |
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