Cumulative Radiation Dose Caused By Radiologic Studies in Critically Ill Trauma Patients
- 1 September 2004
- journal article
- research article
- Published by Wolters Kluwer Health
- Vol. 57 (3), 510-514
- https://doi.org/10.1097/01.ta.0000141028.97753.67
Abstract
Critically ill trauma patients undergo many radiologic studies, but the cumulative radiation dose is unknown. The purpose of this study was to estimate the cumulative effective dose (CED) of radiation resulting from radiologic studies in critically ill trauma patients. The study group was composed of trauma patients at an urban Level I trauma center with surgical intensive care unit length of stay (LOS) greater than 30 days. The radiology records were reviewed. A typical effective dose per study for each type of plain film radiograph, computed tomographic scan, fluoroscopic study, and nuclear medicine study was used to calculate CED. Forty-six patients met criteria. The mean surgical intensive care unit and hospital LOS were 42.7 ± 14.0 and 59.5 ± 28.5 days, respectively. The mean Injury Severity Score was 32.2 ± 15.0. The mean number of studies per patient was 70.1 ± 29.0 plain film radiographs, 7.8 ± 4.1 computed tomographic scans, 2.5 ± 2.6 fluoroscopic studies, and 0.065 ± 0.33 nuclear medicine study. The mean CED was 106 ± 59 mSv per patient (range, 11–289 mSv; median, 104 mSv). Among age, mechanism, Injury Severity Score, and LOS, there was no statistically significant predictor of high CED. The mean CED in the study group was 30 times higher than the average yearly radiation dose from all sources for individuals in the United States. The theoretical additional morbidity attributable to radiologic studies was 0.78%. From a radiobiologic perspective, risk-to-benefit ratios of radiologic studies are favorable, given the importance of medical information obtained. Current practice patterns regarding use of radiologic studies appear to be acceptable.Keywords
This publication has 16 references indexed in Scilit:
- Reformatted Visceral Protocol Helical Computed Tomographic Scanning Allows Conventional Radiographs of the Thoracic and Lumbar Spine to Be Eliminated in the Evaluation of Blunt Trauma PatientsPublished by Wolters Kluwer Health ,2003
- Pelvic Radiography in Blunt Trauma Resuscitation: A Diminishing RolePublished by Wolters Kluwer Health ,2002
- Evaluation of the Lower Spine after Blunt Trauma Using Abdominal Computed Tomographic Scanning Supplemented with Lateral ScanogramsPublished by Wolters Kluwer Health ,2002
- Diagnostic reference levels—the way forwardThe British Journal of Radiology, 2001
- Comparison of Doses for Bedside Examinations of the Chest with Conventional Screen-Film and Computed Radiography: Results of a Randomized Controlled TrialRadiology, 2000
- Value of Complete Cervical Helical Computed Tomographic Scanning in Identifying Cervical Spine Injury in the Unevaluable Blunt Trauma Patient with Multiple Injuries: A Prospective StudyPublished by Wolters Kluwer Health ,1999
- A study of patient radiation doses in interventional radiological procedures.The British Journal of Radiology, 1998
- Revised radiation doses for typical X-ray examinations. Report on a recent review of doses to patients from medical X-ray examinations in the UK by NRPB. National Radiological Protection Board.The British Journal of Radiology, 1997
- Chest radiography in the ICUClinical Imaging, 1997
- Measurement of irradiation doses secondary to bedside radiographs in a medical intensive care unitIntensive Care Medicine, 1987