Does Acuity and Severity of Injury Affect Trauma Whole-Body CT Report Turnaround Time? A Large-scale Study

Abstract

Abstract Trauma is a leading cause of death in the United States. Whole-Body CT is routinely used to screen for major injuries and hemorrhage and to plan interventions. Report Turn-Around-Time (RTAT) plays a role in the flow of patient management and is an objective marker of efficiency that could be improved upon with development and implementation of AI CAD tools for trauma patients. Currently, the degree to which this metric is affected by injury acuity and severity is poorly documented. The study included 11,251 patients who underwent admission trauma whole-body CT at two trauma centers within a single hospital system; a level I trauma center (n=9043) and a regional urban level II trauma center (n=2208). Patients were selected between July 2016 and September 2022. Clinical data and RTAT were extracted from the trauma registry and medical records. Overall median RTAT was 24 minutes (IQR: 4-48). RTAT was significantly longer in those who had hemodynamic shock (37 minutes vs 22 minutes, p<0.0001), polytrauma (ISS≥16) (34 minutes vs 21 minutes, p<0.0001), or massive transfusion (47.5 minutes vs 24 minutes, p<0.0001); those who expired (41 minutes vs 23 minutes,p<0.0001); the older cohort (age>55) (28 minutes vs 22 minutes, p<0.0001), and those with penetrating vs blunt injuries (27 minutes vs 23 minutes, p=0.001). Overall, these findings indicate that increased traumatic injury severity is associated with non-negligible increases in whole-body CT RTATs. The results provide strong justification for computer-aided detection/diagnosis (CAD) research and development to reduce cognitive load and augment diagnostic efficiency in severely injured patients who stand to benefit most from such tools.