Evaluating blunt abdominal trauma with sonography: A cost analysis

Mark G. Mckenney, K. L. McKenney, J. J. Hong, R. Compton, S. M. Cohn, O. C. Kirton, D. V. Shatz, D. Sleeman, P. M. Byers, E. Ginzburg, J. Augenstein

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Ultrasonography (US) is becoming increasingly utilized in the United States for the evaluation of blunt abdominal trauma (BAT). The objective of this study was to assess the cost impact of utilizing US in the evaluation of patients with BAT in a major trauma center. All patients sustaining BAT during a 6-month period before US was used at our institution (Jan-Jun 1993) were compared to BAT patients from a recent period in which US has been utilized (Jan-Jun 1995). The numbers of US, computed tomography (CT), and diagnostic peritoneal lavage (DPL) were tabulated for each group. Financial cost for each of these procedures as determined by our finance department were as follows: US $96, CT $494, DPL $137. These numbers are representative of actual hospital expenditures exclusive of physician fees as calculated in 1994 U.S. dollars. Cost analysis was performed with t test and chi squared test, and significance was defined as P < 0.05. There were 890 BAT admissions in the 1993 study period and 1033 admissions in the 1995 study period. During the 1993 period, 642 procedures were performed on the 890 patients to evaluate the 1/93-6/93 1/95-6/95 exam no. cost exam no. cost US 0 $0 US 552 $52,992 CT 466 $230,204 CT 228 $112,632 DPL 176 $24,112 DPL 21 $2,877 Total 642 $254,316 Total 801 $168,501 abdomen: 0 US, 466 CT, and 176 DPL (see table). This compares to 801 procedures on the 1033 patients in 1995: 552 US, 228 CT, and 21 DPL. Total cost was $254,316 for the 1993 group and $168,501 for the 1995 group. Extrapolated to a 1-year period, a significant (P < 0.05) cost savings of $171,630 would be realized. Cost per patient evaluated was significantly reduced from $285.75 in 1993 to $163.12 in 1995 (P < 0.05). This represents a 43 per cent reduction in per patient expenditure for evaluating the abdomen. By effectively utilizing ultrasonography in the evaluation of patients with blunt abdominal trauma, a significant cost savings can be realized. This effect results chiefly from an eight-fold reduction in the use of DPL, and a two-fold reduction in the use of CT.

Original languageEnglish (US)
Pages (from-to)930-934
Number of pages5
JournalAmerican Surgeon
Issue number10
StatePublished - Dec 1 2001

ASJC Scopus subject areas

  • Surgery


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