To review trauma CT volumes, indications and diagnostic yield for an in-department scanner from 1999-2004 in a busy Level I Trauma Emergency Department.

The trauma registry at our Level I Trauma Center was interrogated for total number of trauma admissions, penetrating versus blunt trauma, patients who underwent an abdominal CT scan in the Emergency Room, diagnostic yield of CT scan, and number of patients who subsequently went to the operating room. These results were tabulated by year and in aggregate to determine if there were significant changes in patterns of usage.

There were 14,086 total trauma admissions to our institution over the 6 year period of this study. The total number of trauma admissions per year increased 14.2% from 2298 in 1999 to 2624 in 2004 (averaging 7 patients admitted per day in 2004.) The percentage of patients with blunt (versus penetrating) trauma was stable over the five year period (85% in 1999 and 87% in 2004.) Total trauma patients who had an abdominal CT in the emergency room at the time of admission increased from 24% in 1999 to 30% in 2004. These were positive for intra-abdominal injury in 23% in 1999 and 26% in 2004. The percentage of patients who underwent CT for Blunt trauma increased from 27% to 32% from 1999 to 2004 and the diagnostic yield for intra-abdominal injury increased from 23% to 26% over the same time period in this cohort. The percentage of patients who underwent CT for Penetrating trauma increased from 11% to 15% from 1999 to 2004 and the diagnostic yield for intra-abdominal injury increased from 21% to 28% over the same time period.

The volume of trauma CT increased by 6% and diagnostic yield increased by 3% over the six year course of this study. Indications and diagnostic yield increased for both blunt and penetrating trauma.

The volume of trauma CT has increased over the last six years at our busy level 1 trauma center; this study demonstrates a concomitant increase in the diagnostic yield for these examinations.