• Annals of surgery · Mar 2022

    Should Radiation Exposure be an Issue of Concern in Children with Multiple Trauma?

    • Anthony Howard, Robert M West, Gareth Iball, Michalis Panteli, Mantaran Singh Baskshi, Hemant Pandit, and Peter V Giannoudis.
    • Leeds Orthopaedic Trauma Sciences, LIRMM, Leeds University, Leeds, UK.
    • Ann. Surg. 2022 Mar 1; 275 (3): 596601596-601.

    ObjectiveThe aims of this study were 3-fold: first, establish the level of radiation exposure experienced by the pediatric trauma patients; second, model the level of risk of developing fatal carcinogenesis; and third, test whether pattern of injury was predictive of the level of exposure.Summary Background DataThere are certain conditions that cause children to be exposed to increased radiation, that is, scoliosis, where level of radiation exposure is known. The extent that children are exposed to radiation in the context of multiple traumas remains unclear.MethodsPatients below the age of 16 years and with an Injury Severity Score (ISS) ≥10, treated by a Major Trauma Center for the period January 2008 to December 2018 were identified. The following data were extracted for the year following the patient's injury: number, doses, and type of radiological examination.The sex and age of the patient was taken into account in the calculation of the risk of developing a carcinogenesis.ResultsThe median radiation dose of the 425 patients identified in the 12 months following injury, through both CT and radiographs, was 24.3 mSv. Modeling the predictive value of pattern of injury and other relevant clinical values, ISS was proportionately predictive of cumulative dose received.ConclusionA proportion of younger polytrauma patients were exposed to high levels of radiation that in turn mean an increased risk of carcinogenesis. However, the ISS, age, injury pattern, and length of hospital stay are predictive of both risks, enabling monitoring and patient advisement of the risks.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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