US white kids get more scans for low-risk head trauma
For lower-risk injuries, white children get more, and likely too many, of the scans according to a US study.
When children have minor, but high-risk, head injuries, race doesn’t seem to be a factor determining who gets sent for CT scanning.
Researchers, whose results appeared in the Archives of Pediatrics & Adolescent Medicine, found that of 39 717 children across the United States with minor head trauma, about 42% of the white children had CT cans of the head while 28% of black and Hispanic children got the scans.
The difference doesn’t mean that black and Hispanic children were getting worse care, the researchers said. Rather, the white children could be getting unnecessary and potentially risky care - in part, because their parents demand it.
“It’s often that the minority groups get worse care, but what we found is that the whites are more likely to get CT scans that are not indicated and could be risky because of the radiation exposure, said JoAnne Natale, the study’s lead author and a professor of pediatrics at the University of California, Davis.
“(In this case) it’s actually opposite because the black sand Hispanics are getting better care... and the whites are getting too much (care).”
Traumatic brain injuries — usually caused by blows to the head — account for more than 7 000 deaths, 60 000 hospital admissions and 600 000 emergency room visits in the United States every year, according to Natale and her colleagues.
Past research has found that black kids typically fare worse than whites after such an injury.
To see whether there were racial differences in the treatment kids received, Natale’s group looked at who got a head CT, a fairly typical scan for head injury, in emergency rooms.
They analyzed data from a large existing study looking at 25 emergency rooms across the United States, where doctors were asked to complete questionnaires about children treated for head trauma between June 2004 and September 2006.
The study covered more than 42000 children under 18 seen within 24 hours of a minor head injury. “Minor” was defined as more serious than just a bump on the head, but excluded very severe head trauma.
Within the minor injury category, there can be high, intermediate and low levels of risk, as determined by the specific circumstances of the injury and the child’s symptoms.
Children in the highest risk groups typically get CT scans because their symptoms are serious, such as unconsciousness.
There were no differences in treatment based on race or ethnicity, Natale and her colleagues found.
But in the intermediate risk group, 58% of white children got scans compared to 51% of black children.
In the lowest-risk group, 17% of white children got scanned compared to 10% of the black and Hispanic children.
Natale and her team said they couldn’t say from their data why white children got scanned more. But across the board, doctors said parental anxiety and requests played more of a role in treatment of white children.
Other factors may be at work as well, since the results didn’t take into account insurance status or specific reasons doctors didn’t order a CT scan for some children.