Évaluation de l'utilisation de la tomodensitométrie dans un système de traumatologie intégré chez les patients transférés : une étude de cohorte multicentrique

Authors: Abiala, Olachodjoumi Jean
Advisor: Moore, Lynne
Abstract: Clinical guidelines advise against computed tomography (CT) imaging performed at referral centers in patients with an indication for immediate transfer as well as repeat CT scans at the major trauma center. We conducted a multicenter retrospective cohort study to estimate the incidence of pre- and posttransfer CT overall and in injury groups with an indication for immediate transfer (moderate to severe traumatic brain injuries, spinal cord injuries, severe pelvic fractures, and multi-system trauma). We also assessed interhospital variation; identified predictors; and quantified the influence of pre-transfer CT on delays to transfer. We observed that more than half and more than one-third of patients underwent pre- and post-transfer CT imaging, respectively. Interhospital variation was moderate for pre-transfer CT and lower for repeat post-transfer CT. Increased age, male sex, falls, and certain pre-existing conditions were associated with an increased odds of pre-transfer CT. Repeat post-transfer CT was associated with study year, age, head injury, injury severity, certain pre-existing conditions, and designation level of the referral center. Regardless of trauma types, delays to transfer were doubled in patients who had a pre-transfer CT. This information may be used to drive improvements adherence to clinical practice guidelines.
Document Type: Mémoire de maîtrise
Issue Date: 2021
Open Access Date: 13 September 2021
Permalink: http://hdl.handle.net/20.500.11794/70306
Grantor: Université Laval
Collection:Thèses et mémoires

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