Measuring the Impact of Whole-Body Computed Tomography on Hospital Length of Stay in Blunt Trauma

Rationale and Objectives: Whole-body computed tomography (WBCT) imaging has become commonplace in some emergency departments (EDs) for trauma where management is dependent on rapid diagnosis achieved through comprehensive imaging. The purpose of this study was to assess the value that computed tomography (CT) imaging contributes to trauma patients by retrospectively comparing hospital length of stay (LOS) between WBCT and selective CT imaging, while controlling for hemodynamic stability and socioeconomic considerations. Materials and Methods: This study was institutional review board approved. The institutional trauma registry database was cross-referenced with our radiology information system database to identify adult patients who sustained blunt trauma between July 2011 and June 2013 and received CT imaging. Propensity score weighting was utilized to achieve balance in baseline covariates, including demographics, hemodynamic stability, Glasgow Coma Scale, and socioeconomic factors. A generalized linear model was used to compare LOS between imaging types, and a multinomial logistic regression was utilized to analyze differences in discharge disposition. Results: A total of 2291 patients were identified of which 14.5% underwent WBCT imaging. WBCT patients had an insignificantly longer inpatient hospital LOS of 0.31 days (P = 0.54), and insignificantly higher odds of being discharged to a nursing home facility (versus home, odds ratio = 1.29 [P = 0.34]) when compared to those who received selective CT. Conclusion: WBCT imaging did not have a statistically significant effect on inpatient hospital LOS or discharge disposition.