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, Rachael Moorin

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose. Whilst 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.
Method. A 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.
Results. Amongst 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.
Conclusions. Instead 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.
Original languageEnglish
Pages (from-to)2413-2427
Number of pages15
JournalEuropean Journal of Trauma and Emergency Surgery
Volume49
Issue number6
Early online date15 Jun 2023
DOIs
Publication statusPublished - Dec 2023

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