Work

Discrepancies between community interpretations and emergency radiology re-interpretation of imaging exams on trauma patients transferred to a level 1 trauma center

Year: 2025

Type: article

Abstract: PURPOSE: To evaluate the rate of discrepancies between community radiologists’ interpretations of trauma studies and those of the emergency radiologists at an academic level 1 trauma center and to assess the impact on patient management provided by emergency radiologist overreads. METHODS: A search of our institutional Radiology Information System (RIS) was performed to find outside overread interpretations that were performed by emergency radiologists at our institution in a 1-year period (January 1, 2023-December 31, 2023). For these patients, the outside report was obtained and compared to the emergency radiologist overread report. Discrepancies between reports were divided into major and minor discrepancies. A major discrepancy was defined as a change in interpretation that resulted in altered patient management (including interventional radiology procedure or surgery). A minor discrepancy was defined as a change in interpretation that did not alter patient management. RESULTS: The study cohort consisted of 301 imaging exams performed on 135 patients. The mean age was 52.3 years (range 19–97 years), included 68 males (63.7%), and a mean Injury Severity Score (ISS) of 13 (range 1–51). Patients were transferred from 29 different facilities from around our state. The most common mechanism of injury was fall (n = 128, 42.5%) followed by motor vehicle collisions (MVC, n = 103, 34.2%) and assaults (n = 25, 8.3%). Major discrepancies were found in 26 exams (8.6%) affecting 25 patients (18.5%), of which 7 required surgery or an interventional radiology procedure. Minor discrepancies were found in 49 exams (16.3%) affecting 42 patients (31.1%). In total, some discrepancy was found in 75 (24.9%) of exams affecting 62 patients (49.6%). There is a statistically significant association with a discrepancy following MVC compared to the other mechanisms of injury (p = 0.0228). CONCLUSIONS: We found that nearly a quarter (24.9%) of overread imaging exams affecting nearly half (49.6%) of transferred trauma patients had a discrepancy in the original report, resulting in a change in management in 18.5% of patients, with over a quarter (26.9%) of major discrepancies requiring surgery or interventional radiology procedures. Motor vehicle collisions were associated with an increased likelihood of a discrepancy. Our findings continue to support the value of reinterpretation of outside imaging exams by dedicated emergency radiologists in the setting of trauma.

Source: Emergency Radiology

DOI: 10.1007/s10140-025-02421-7

Authors: Allison Crone, Josh VanZant, Alexander Boutselis, Scott D. Steenburg