Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Effective Radiologic Doses and Lifetime Attributable Risks in Patients with Trauma Critical Pathway Activation

중증외상환자의 전산화단층촬영 및 중재술에 의한 방사선 유효선량 및 생애 귀속위험도

  • Lee, Wonhyo (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • Kong, Taeyoung (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • Kim, Seunghwan (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • You, Je Sung (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • Park, Yoo Seok (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • Lee, Jae Gil (Division of Surgical Critical Care & Trauma, Department of Surgery, Yonsei University College of Medicine) ;
  • Chung, Sung Phil (Department of Emergency Medicine, Yonsei University College of Medicine)
  • 이원효 (연세대학교 의과대학 응급의학교실) ;
  • 공태영 (연세대학교 의과대학 응급의학교실) ;
  • 김승환 (연세대학교 의과대학 응급의학교실) ;
  • 유제성 (연세대학교 의과대학 응급의학교실) ;
  • 박유석 (연세대학교 의과대학 응급의학교실) ;
  • 이재길 (연세대학교 의과대학 외과학교실) ;
  • 정성필 (연세대학교 의과대학 응급의학교실)
  • Received : 2013.08.23
  • Accepted : 2013.09.09
  • Published : 2013.09.30
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Abstract

Purpose: This study was performed to calculate and analyze the effective radiation doses from computed tomography (CT) and radiologic intervention in patients in the emergency department (ED) with trauma critical pathway (CP) activation and further to estimate the lifetime attributable risks (LARs) for the incidence of and mortality from cancers induced by the radiation dose. Methods: Through a retrospective electrical chart review of 104 injured patients who trauma critical pathway were activated from November 2012 to March 2013, we calculated effective radiologic doses by taking the product of the dose-linear product of the scan and the conversion coefficient. After a determination of the image results, we divided the patients into two groups, negative or positive, and calculated the effective dose for each group. With these results, we estimated the LARs for the incidence of and the mortality from cancers by using the table in the Biologic Effects of Ionizing Radiation (BEIR)-VII report. Results: A total of 76 patients were enrolled. The mean age was $49.0{\pm}8.5$ years. The mean injury severity score (ISS) was $12.7{\pm}8.4$. The cumulative effective dose (CED) for individual patients varied from 2.8 mSv to 238.8 mSv, and the mean was $47.6{\pm}39.9$ mSv. The CED in patients with an $ISS{\geq}16$($63.2{\pm}26.6$ mSv) was higher than that of patients whose ISS<16($33.5{\pm}23.1$ mSv) (p<0.001). The CED in patients who were treated with surgery or intervention($69.0{\pm}45.2$ mSv) was higher than that of patients who were treated conservatively($33.6{\pm}22.4$ mSv) (p<0.001). The LARs for cancer incidence and mortality were $328.5{\pm}308.6$ and $189.0{\pm}159.3$ per 100,000 people, respectively. Conclusion: The CED and the LAR for trauma CP-activated patients in the ED were significant, so efforts should be made to decrease the effective dose received by severely injured patients.

Keywords

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