Racial Disparity in CT Use for Children With Head Trauma

White children with low, intermediate injury risk more likely to receive CT than black, Hispanic peers

WEDNESDAY, Aug. 8 (HealthDay News) -- Minority children with minor blunt head trauma and low or intermediate risk for clinically important traumatic brain injury are significantly less likely to receive cranial computed tomography (CT) in the emergency department than their nonminority peers with the same risk, according to a study published in the August issue of the Archives of Pediatrics & Adolescent Medicine.

JoAnne E. Natale, M.D., Ph.D., from the University of California Davis in Sacramento, and colleagues examined whether patient race was associated with cranial CT use among children with minor blunt head trauma. Data were used from 39,717 children (<18 years) who were seen within 24 hours of injury and were white non-Hispanic, black-non-Hispanic, or Hispanic. Injury severity was described using a previously validated clinical prediction rule that classified each child's risk for clinically important traumatic brain injury.

The researchers found that 34.7 percent of children underwent cranial CT. For children at higher risk for clinically important traumatic brain injury, the odds of undergoing cranial CT did not differ by race/ethnicity. For children at intermediate risk or lowest risk, minority (black non-Hispanic or Hispanic) children had significantly lower odds of undergoing cranial CT (odds ratios, 0.86 and 0.72, respectively). For children of white non-Hispanic race/ethnicity, parental anxiety and request was commonly cited by physicians as an important influence for ordering cranial CT, regardless of risk for clinically important traumatic brain injury.

"Disparities may arise from the overuse of cranial CT among patients of nonminority races/ ethnicities," the authors write.

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