Time to Computed Tomography for Major Trauma Patients: 10-Year Trends at a Level-1 Trauma Centre

Introduction

Computed tomography (CT) is an essential part of trauma patient initial workup. Rapid performance of CT has become the standard of care in most parts of the world. This study aims to assess if the time to CT has changed over a 10-year period at the study centre and examine the potential impact on patient outcomes.

Methods

A retrospective audit of prospectively collected trauma registry from 2010 to 2019 was performed, including trauma presentations to John Hunter Hospital (n = 9712) with injury severity score above 15. CT data, including start time, end time, time to CT and body region imaged, were collected from RIS-PACS.

Results

Time to CT over the 10-year period ranged from 6 to 299, with a mean of 92 min. Regression analysis showed no overall change in time to CT. Patients who arrived intubated, polytrauma patients and those with isolated head injuries had faster time to CT. Longer time to CT was seen in patients hypotensive on arrival.

Conclusions

Time to CT in trauma patients has not changed over a 10-year period, remaining below international standards. In-hospital mortality of major trauma patients at our institution continued to decrease over the study timeframe, resulting in one of the lowest risk-adjusted mortality rates in the country. Development and publication of an Australian KPI for Time to CT in Trauma patients is an important next step in Australian trauma policy and guidelines. This study will serve as a baseline for reassessment of trauma patient initial management workflow within the hospital following the addition of a new acute care services block, protocols for suitable major trauma patients to bypass the emergency resuscitation bay, and a CT hybrid room through our institution's expansion.