• Eur J Trauma Emerg Surg · Dec 2023

    Observational Study

    Patterns of computed tomography utilisation in injury management: latent classes approach using linked administrative data in Western Australia.

    • Ninh T Ha, Mark Harris, Max Bulsara, Jenny Doust, Sviatlana Kamarova, Donald McRobbie, Peter O'Leary, Paul M Parizel, John Slavotinek, Cameron Wright, David Youens, and Rachael Moorin.
    • Health Economics and Data Analytics, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. thi.ha@curtin.edu.au.
    • Eur J Trauma Emerg Surg. 2023 Dec 1; 49 (6): 241324272413-2427.

    PurposeWhilst computed tomography (CT) imaging has been a vital component of injury management, its increasing use has raised concern regarding ionising radiation exposure. This study aims to identify latent classes (underlying patterns) of CT use over a 3-year period following the incidence of injury and factors predicting the observed patterns.MethodA retrospective observational cohort study was conducted in 21,544 individuals aged 18 + years presenting to emergency departments (ED) of four tertiary public hospitals with new injury in Western Australia. Mixture modelling approach was used to identify latent classes of CT use over a 3-year period post injury.ResultsAmongst injured people with at least one CT scan, three latent classes of CT use were identified including a: temporarily high CT use (46.4%); consistently high CT use (2.6%); and low CT use class (51.1%). Being 65 + years or older, having 3 + comorbidities, history with 3 + hospitalisations and history of CT use before injury were associated with consistently high use of CT. Injury to the head, neck, thorax or abdomen, being admitted to hospital after the injury and arriving to ED by ambulance were predictors for the temporarily high use class. Living in areas of higher socio-economic disadvantage was a unique factor associated with the low CT use class.ConclusionsInstead of assuming a single pattern of CT use for all patients with injury, the advanced latent class modelling approach has provided more nuanced understanding of the underlying patterns of CT use that may be useful for developing targeted interventions.© 2023. The Author(s).

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