White kids get more scans for low-risk head trauma

When kids have minor, but high-risk, head injuries, race doesn't seem to be a factor determining who gets sent for CT scanning, a new study finds. But for lower-risk injuries, white children are getting more - and likely too many - of the scans.

Researchers found that of 39,717 children across the U.S. with minor head trauma, about 42 percent of the white kids had computed tomography - a high-powered X-ray - of the head while 28 percent of black and Hispanic children got the scans.

The difference does not mean that black and Hispanic children were getting worse care, the researchers say. 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 Dr. JoAnne Natale, the study's lead author and a professor of pediatrics at the University of California, Davis.

In this case, Natale said, "it's actually opposite because the blacks and 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, who published their findings in the Archives of Pediatrics & Adolescent Medicine on Monday.

Past research, they note, has found that black kids typically fare worse than whites after such an injury.

CT SCANS BY RACE

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 in cases of head injury - in emergency rooms.

They analyzed data from a large existing study looking at 25 emergency rooms across the U.S., where doctors were asked to complete questionnaires about children treated for head trauma between June 2004 and September 2006.

The study covered more than 42,000 children under 18 seen within 24 hours of a minor head injury.

Minor means the child had something more serious than just a bump on the head, but it excludes very severe head traumas.

Still, there can be unseen internal damage and within the minor-injury category, there are 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 - such as unconsciousness - are so serious. In that category, Natale and her colleagues did not see any differences in treatment based on race or ethnicity. Around 80 percent of all kids got scans.