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Department of Radiology Technology, School of Allied Medicine, Birjand University of Medical Sciences, Birjand, Iran
Abstract: (20 Views)
Introduction: Computed tomography (CT) has become an indispensable tool in the diagnostic workup of trauma patients. Nevertheless, the growing reliance on CT imaging has raised significant concerns about unnecessary exposure to ionizing radiation, particularly in cases where clinical justification is lacking. Despite the existence of well-established guidelines, such as those provided by the American College of Radiology and Advanced Trauma Life Support, a notable proportion of CT requests continue to fall outside recommended indications. Therefore, the present study seeks to assess the clinical justification of CT scan utilization in trauma settings, with an emphasis on both the appropriateness of imaging use and adherence to radiation protection principles.
Methods: This retrospective descriptive-analytical study was carried out at Imam Reza Hospital in Birjand, Iran, a leading trauma referral center in the region. Medical records of 400 trauma patients who underwent CT imaging were reviewed. The extracted data included patient demographics, types and frequencies of CT scans, the referring departments, and the presence or absence of traumatic injuries on imaging. Justification for each CT request was evaluated using clinical notes, radiological findings, and guideline-based criteria. Data analysis was performed using descriptive statistics and Pearson’s chi-square tests to identify significant patterns.
Results: Out of 678 CT scan requests analyzed, 70% were classified as clinically justified. However, justification rates varied widely depending on the scan type and referring department. Whole-body CT (WBCT) scans showed the lowest rate of justification (28.69%), while abdominal CT scans exhibited the highest (81.36%). Thoracic and facial CTs also demonstrated high diagnostic yields. Neurosurgery departments submitted the most CT requests overall, whereas male orthopedic surgeons achieved the highest justification rates for WBCT. The financial assessment revealed over 600 million Iranian Rials (IRR) in direct losses due to unjustified imaging, alongside notable resource burdens in staff time and equipment depreciation. No statistically significant differences were observed between male and female patients in justification rates across anatomical regions (all p>0.05).
Conclusion: While the overall rate of justified CT use in trauma care was acceptable, a substantial portion, particularly WBCT requests, lacked adequate clinical indication. Strengthening clinical assessment protocols, promoting adherence to evidence-based imaging guidelines, and increasing physician awareness are essential strategies to prevent unnecessary CT usage. Such measures can enhance patient safety, conserve healthcare resources, and support more sustainable trauma imaging practices.
Methods: This retrospective descriptive-analytical study was carried out at Imam Reza Hospital in Birjand, Iran, a leading trauma referral center in the region. Medical records of 400 trauma patients who underwent CT imaging were reviewed. The extracted data included patient demographics, types and frequencies of CT scans, the referring departments, and the presence or absence of traumatic injuries on imaging. Justification for each CT request was evaluated using clinical notes, radiological findings, and guideline-based criteria. Data analysis was performed using descriptive statistics and Pearson’s chi-square tests to identify significant patterns.
Results: Out of 678 CT scan requests analyzed, 70% were classified as clinically justified. However, justification rates varied widely depending on the scan type and referring department. Whole-body CT (WBCT) scans showed the lowest rate of justification (28.69%), while abdominal CT scans exhibited the highest (81.36%). Thoracic and facial CTs also demonstrated high diagnostic yields. Neurosurgery departments submitted the most CT requests overall, whereas male orthopedic surgeons achieved the highest justification rates for WBCT. The financial assessment revealed over 600 million Iranian Rials (IRR) in direct losses due to unjustified imaging, alongside notable resource burdens in staff time and equipment depreciation. No statistically significant differences were observed between male and female patients in justification rates across anatomical regions (all p>0.05).
Conclusion: While the overall rate of justified CT use in trauma care was acceptable, a substantial portion, particularly WBCT requests, lacked adequate clinical indication. Strengthening clinical assessment protocols, promoting adherence to evidence-based imaging guidelines, and increasing physician awareness are essential strategies to prevent unnecessary CT usage. Such measures can enhance patient safety, conserve healthcare resources, and support more sustainable trauma imaging practices.
Type of Study: Research |
Subject:
Trauma
Received: 2025/07/7 | Accepted: 2026/07/12 | ePublished ahead of print: 2026/11/15
Received: 2025/07/7 | Accepted: 2026/07/12 | ePublished ahead of print: 2026/11/15
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