Investigating the Potential Overuse of Pan-Computed Tomography (PanCT) Examinations in Emergency Departments

The increasing use of whole-body computed tomography (WBCT) examinations, also known as panCT, in emergency departments for trauma patients has raised concerns about potential over-use and the associated risk of unnecessary radiation exposure. The purpose of this study was to examine the utilization patterns and findings of panCT scans performed over one year at a major academic hospital. This retrospective cohort study included 599 trauma patients (adults and pe-diatrics) who underwent panCT scans in 2023. De-identified data for each patient, including the radiology report, age, gender, and dose-length product (DLP), were retrieved and reviewed. Ra-diology reports were classified as negative (no acute traumatic injuries) or positive, with posi-tive cases further subclassified based on injury location. Injury severity scores (ISS) were also calculated based on the findings of the radiology reports. Statistical analysis was performed us-ing Python programming language to assess predictors of report findings. Overall, 56% of panCT scans were negative. Logistic regression showed that age significantly impacted the like-lihood of negative findings (p=0.009), while gender did not (p=0.182). One-third of positive cases showed injuries either in head and neck (HN) or chest-abdomen-pelvis (CAP) regions. Most cases (70% adults, 65% pediatrics) had an ISS between 1 and 8. Median DLP values were 2264 mGy.cm in pediatrics and 2666 mGy.cm in adults. The study showed a high rate of negative panCT scans, suggesting potential overuse of panCT. These findings highlight the need for more selective CT imaging approaches, evidence-based guidelines, and decision-support tools to promote appropriate utilization of panCT scans, reducing unnecessary radiation exposure while ensuring high-risk patients receive appropriate imaging.