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Minority children less likely to receive CT scans following head trauma

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Alexander J. Rogers

African-American and Hispanic children are less likely than Caucasian children to receive a cranial CT scan in an emergency department following minor head trauma, according to a study presented at the 2011 American Academy of Pediatrics National Conference and Exhibition.

“Our study demonstrates that among children with minor head trauma but at low risk for clinically important brain injury, white children receives cranial CT scans more frequently than black or Hispanic children,” study author Alexander Rogers, MD, FAAP, stated in an American Academy of Pediatrics press release. “In this low-risk population, higher rates of cranial CT may represent overuse in white children, leading to increased radiation exposure and health care costs.”

The authors performed a secondary data analysis on a cohort of 42,412 children younger than 18 years who experienced minor head trauma and presented with Glasgow Coma Scale scores of 14 or 15 at 25 emergency departments (EDs) in the Pediatric Emergency Care Applied Research Network. Rates of CT with generalized estimating equations used to control for each child’s potential for traumatic brain injury, among other patient characteristics.

Of the 42,412 children, 39,717 (94%) were either Hispanic, African-American or Caucasian. Thirty-five percent (13,793) of these children received CT imaging. The team found no significant differences by race or ethnicity when looking at CT rates in the children at a higher risk for traumatic brain injury, but noted Caucasian children who were at a lower risk for such injury were more likely than Hispanic or African-American children to receive a CT scan. Further, Caucasian children with intermediate risk of brain injury were found to be significantly more likely than African-American children to receive a CT scan.

The authors noted further studies are needed to focus on explaining these racial differences in the use of imaging.

“The cause of this disparity is likely multifactorial, but this study highlights the importance of strong, evidence-based guidelines to assure equal and optimal care,” Rogers stated.

Reference:

• Natale JE, Joseph JG, Rogers AJ, et al. Cranial CT use for minor head trauma in children is associated with race/ethnicity. Paper 13084. Presented at the 2011 American Academy of Pediatrics National Conference and Exhibition. Oct. 15-18. Boston.

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