OBJECTIVES: To quantify rates and variation in @entity341 ( @entity341 ) cranial computed tomography (CT) utilization in @entity1 with ventricular shunts, estimate radiation exposure, and evaluate the association between CT utilization and shunt revision. STUDY DESIGN: Retrospective longitudinal cohort study of @entity341 visits from 2003-2013 in @entity1 0-18  years old with initial shunt placement in 2003. Data were examined from 31 hospitals in the Pediatric Health Information System. Main outcomes were cranial CT performed during an @entity341 visit, estimated cumulative effective radiation dose, and shunt revision within 7  days. Multivariable regression modeled the relationship between @entity1 - and hospital-level covariates and CT utilization. RESULTS: The 1319 @entity1 with initial shunt placed in 2003 experienced 6636 @entity341 visits during the subsequent decade. A cranial CT was obtained in 49.4% of all @entity341 visits; 19.9% of @entity341 visits with CT were associated with a shunt revision. Approximately 6% of @entity1 received >= 10 CTs, accounting for 37.2% of all @entity341 visits with a CT. The mean number of CTs per @entity1 varied nearly 20-fold across hospitals; the individual hospital accounted for the most variation in CT utilization. The median (IQR) cumulative effective radiation dose was 7.2 millisieverts (3.6-14.0) overall, and 33.4 millisieverts (27.2-43.8) among @entity1 receiving >= 10 CTs. CONCLUSIONS: A CT scan was obtained in half of @entity341 visits for @entity1 with a ventricular shunt, with wide variability in utilization by hospitals. Strategies are needed to identify @entity1 at risk of @entity5033 to reduce variability in CT utilization and radiation exposure in the @entity341 .

Emergency Department Use of Computed Tomography for XXXX with Ventricular Shunts.

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'patient'] @entity341 :: ('MESH:D004630', 'Disease') :: ['emergency department', 'ED'] @entity5033 :: ('MESH:C562451', 'Disease') :: ['shunt malfunction']
@entity1 :: (9606,Species) :: ['Children']
