Details
| Original language | English |
|---|---|
| Article number | e16320 |
| Journal | Medicine |
| Volume | 98 |
| Issue number | 28 |
| Publication status | Published - Jul 2019 |
Abstract
To investigate the use of neuroimaging in children and adolescents with minor brain injury in pediatric and non-pediatric departments.In this observational cohort study data were extracted from a large German statutory health insurance (AOK Plus Dresden ∼3.1 million clients) in a 7-year period (2010-2016). All patients with International Classification of Diseases (ICD) code S06.0 (concussion; minor brain injury; commotio cerebri) aged ≤ 18 years were included. Demographic and clinical data were analyzed by logistic regression analysis for associations with the use of CT and MRI (independent variables: gender, age, length of stay, pediatric vs non-pediatric department, university vs non-university hospital).A total of 14,805 children with minor brain injuries (mean age 6.0±5.6; 45.5% females) were included. Treatment was provided by different medical departments: Pediatrics (N=8717; 59%), Pediatric Surgery (N=3582, 24%), General Surgery (N=2197, 15%), Orthopedic Trauma Surgery (N=309, 2.1%). Patients admitted to pediatric departments (Pediatrics and Pediatric Surgery) underwent head CT-imaging significantly less frequently (3.8%) compared to patients treated in non-pediatric departments (18.5%; P<.001; General Surgery: 15.6%; Orthopedic Trauma Surgery: 39.2%). Logistic regression confirmed a significantly higher odds ratio (OR) for the use of cranial CT by the non-pediatric departments (OR: 3.2 [95-%-CI: 2.72-3.76]).CT was significantly less frequently used in pediatric departments. Educational efforts and quality improvement initiatives on physicians, especially in non-pediatric departments may be an effective approach to decreasing rates of CT after minor traumatic brain injuries.
Keywords
- CT-imaging, neuroimaging, non-pediatric departments, pediatric departments, pediatric minor brain injury
ASJC Scopus subject areas
- Medicine(all)
- General Medicine
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In: Medicine, Vol. 98, No. 28, e16320, 07.2019.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Frequency of neuroimaging for pediatric minor brain injury is determined by the primary treating medical department
AU - Klora, Mike
AU - Zeidler, Jan
AU - Bassler, Stefan
AU - Hirsch, Franz Wolfgang
AU - Gosemann, Jan Hendrik
AU - Lacher, Martin
AU - Zimmermann, Peter
N1 - Funding information: We acknowledge support from the German Research Foundation (DFG) and Leipzig University within the program of Open Access Publishing.
PY - 2019/7
Y1 - 2019/7
N2 - To investigate the use of neuroimaging in children and adolescents with minor brain injury in pediatric and non-pediatric departments.In this observational cohort study data were extracted from a large German statutory health insurance (AOK Plus Dresden ∼3.1 million clients) in a 7-year period (2010-2016). All patients with International Classification of Diseases (ICD) code S06.0 (concussion; minor brain injury; commotio cerebri) aged ≤ 18 years were included. Demographic and clinical data were analyzed by logistic regression analysis for associations with the use of CT and MRI (independent variables: gender, age, length of stay, pediatric vs non-pediatric department, university vs non-university hospital).A total of 14,805 children with minor brain injuries (mean age 6.0±5.6; 45.5% females) were included. Treatment was provided by different medical departments: Pediatrics (N=8717; 59%), Pediatric Surgery (N=3582, 24%), General Surgery (N=2197, 15%), Orthopedic Trauma Surgery (N=309, 2.1%). Patients admitted to pediatric departments (Pediatrics and Pediatric Surgery) underwent head CT-imaging significantly less frequently (3.8%) compared to patients treated in non-pediatric departments (18.5%; P<.001; General Surgery: 15.6%; Orthopedic Trauma Surgery: 39.2%). Logistic regression confirmed a significantly higher odds ratio (OR) for the use of cranial CT by the non-pediatric departments (OR: 3.2 [95-%-CI: 2.72-3.76]).CT was significantly less frequently used in pediatric departments. Educational efforts and quality improvement initiatives on physicians, especially in non-pediatric departments may be an effective approach to decreasing rates of CT after minor traumatic brain injuries.
AB - To investigate the use of neuroimaging in children and adolescents with minor brain injury in pediatric and non-pediatric departments.In this observational cohort study data were extracted from a large German statutory health insurance (AOK Plus Dresden ∼3.1 million clients) in a 7-year period (2010-2016). All patients with International Classification of Diseases (ICD) code S06.0 (concussion; minor brain injury; commotio cerebri) aged ≤ 18 years were included. Demographic and clinical data were analyzed by logistic regression analysis for associations with the use of CT and MRI (independent variables: gender, age, length of stay, pediatric vs non-pediatric department, university vs non-university hospital).A total of 14,805 children with minor brain injuries (mean age 6.0±5.6; 45.5% females) were included. Treatment was provided by different medical departments: Pediatrics (N=8717; 59%), Pediatric Surgery (N=3582, 24%), General Surgery (N=2197, 15%), Orthopedic Trauma Surgery (N=309, 2.1%). Patients admitted to pediatric departments (Pediatrics and Pediatric Surgery) underwent head CT-imaging significantly less frequently (3.8%) compared to patients treated in non-pediatric departments (18.5%; P<.001; General Surgery: 15.6%; Orthopedic Trauma Surgery: 39.2%). Logistic regression confirmed a significantly higher odds ratio (OR) for the use of cranial CT by the non-pediatric departments (OR: 3.2 [95-%-CI: 2.72-3.76]).CT was significantly less frequently used in pediatric departments. Educational efforts and quality improvement initiatives on physicians, especially in non-pediatric departments may be an effective approach to decreasing rates of CT after minor traumatic brain injuries.
KW - CT-imaging
KW - neuroimaging
KW - non-pediatric departments
KW - pediatric departments
KW - pediatric minor brain injury
UR - http://www.scopus.com/inward/record.url?scp=85069833556&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000016320
DO - 10.1097/MD.0000000000016320
M3 - Article
C2 - 31305419
AN - SCOPUS:85069833556
VL - 98
JO - Medicine
JF - Medicine
SN - 0025-7974
IS - 28
M1 - e16320
ER -