Minority children less likely to undergo CT after minor head trauma

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African-American and Hispanic children are less likely to receive a cranial CT scan in an emergency department (ED) after a minor head trauma than white children, according to an abstract present Oct. 14 at the American Academy of Pediatrics National Conference and Exhibition in Boston. The results may indicate CT overuse in white children, according to researchers.

While there was a difference in CT rates based on ethnicity after minor head traumas, in cases where a child was deemed to be at high risk for traumatic brain injury there were no significant racial or ethnic disparities in CT scan rates.

Alexander J. Rogers, MD, of the departments of emergency medicine and pediatrics, University of Michigan Medical Center, and the University of Michigan School of Medicine in Ann Arbor, and colleagues wanted to examine racial disparities in healthcare and targeted pediatric ED cases, where less is known regarding the disparities in care.

Researchers reviewed existing data on children seeking care in 25 Pediatric Emergency Care Applied Research Network trauma centers, breaking down CT use compared with the child’s potential for traumatic brain injury.

Of the 42,412 children enrolled in the main study, all of whom were evaluated for head trauma, 94 percent had a documented race/ethnicity of Hispanic, African-American or white. Of these, 35 percent were imaged with CT.

For those at the lowest risk of traumatic brain injury, 17 percent of white children received CTs compared with 9 percent and 12 percent of African-American and Hispanic children, respectively.

"The cause of this disparity is likely multi-factorial, but this study highlights the importance of strong, evidence-based guidelines to assure equal and optimal care," Rogers said in a statement. "In this low-risk population, higher rates of cranial CT may represent overuse in white children, leading to increased radiation exposure and healthcare costs.”

Rogers and colleagues concluded that more research should be done to explain the cause of these racial differences in the use of neuroimaging.