Routine versus selective chest and abdominopelvic CT-scan in conscious blunt trauma patients: a randomized controlled study

Moussavi, N. and Ghani, H. and Davoodabadi, A. and Atoof, F. and Moravveji, A. and Saidfar, S. and Talari, H. (2018) Routine versus selective chest and abdominopelvic CT-scan in conscious blunt trauma patients: a randomized controlled study. European Journal of Trauma and Emergency Surgery, 44 (1). pp. 9-14.

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Purpose: CT-scan is increasingly used in blunt trauma, but the real impact on patient outcome is still unclear. This study was conducted to assess the effect of performing routine (versus selective) chest and abdominopelvic CT-scan on patient admission time and outcome in blunt trauma. Methods: Conscious and hemodynamically stable high-energy trauma patients were included (n = 140). Routine chest and abdominopelvic CT-scan was requested in addition to the conventional radiography and ultrasound for the intervention group and selective CT-scan according to clinical presentation was done for the control group. Patient admission times in the emergency room and surgery ward, complications, and performed surgical procedures were assessed. �Unsuspected injuries� defined as additional findings on CT-scan, which were not expected before CT-scan, were evaluated. Results: Admission time in the emergency ward and admission time in hospital were significantly shorter in the intervention group. Complications were similar in both groups. Abdominopelvic CT-scan in the intervention group revealed nine (7.8) unsuspected injuries. All of these nine patients had also a positive clinical examination and injuries in other body regions. Chest CT-scan in the intervention group led to additional diagnoses in 17 patients (24.28) leading to tube thoracostomy in 13 patients (18.57). Conclusion: Routine chest and abdominopelvic CT-scan in conscious blunt trauma patients decreases the hospitalization time, but has no impact on patient outcome and probably might lead to overtreatment of occult injuries. The option of using a selective approach should be further evaluated to decrease radiation exposure and facility overuse. © 2017, Springer-Verlag GmbH Germany.

Item Type: Article
Additional Information: cited By 2
Uncontrolled Keywords: abdominal injury; adult; blunt trauma; comparative study; controlled study; diagnostic imaging; female; health service; hospitalization; human; intensive care; length of stay; male; middle aged; patient selection; predictive value; randomized controlled trial; statistics and numerical data; thoracostomy; thorax injury; x-ray computed tomography, Abdominal Injuries; Adult; Critical Care; Female; Hospitalization; Humans; Length of Stay; Male; Medical Overuse; Middle Aged; Patient Selection; Predictive Value of Tests; Thoracic Injuries; Thoracostomy; Tomography, X-Ray Computed; Wounds, Nonpenetrating
Subjects: Medicine
Divisions: Faculty of Medicine > Clinical Sciences > Department of Radiology
Depositing User: ART . editor
Date Deposited: 14 Apr 2019 12:59
Last Modified: 14 Apr 2019 12:59

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