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Four years of experience as a major trauma centre results in no improvement in patient selection for whole-body CT scans following blunt trauma

  • Philip BeakEmail author
  • Ben Gabbott
  • Michael Williamson
  • Caroline B. Hing
Original Article • TRAUMA - SCANNER

Abstract

Introduction

Management of major trauma patients with evidence of polytrauma involves the use of immediate whole-body CT (WBCT). Identification of patients appropriate for immediate WBCT remains challenging. Our study aimed to assess for improvement in patient selection for WBCT over time as a major trauma centre (MTC).

Methods

We conducted a retrospective study of patients who presented to our MTC during distinct two-month periods, one in 2013 and the other in 2017. Patients over 18 years of age who presented primarily following blunt trauma and activated a major trauma call were included. All patients underwent either immediate WBCT or standard ATLS workup. Those undergoing WBCT had the results of their scan recorded as positive or negative.

Results

A total of 516 patients were included, 232 from 2 months in 2013 and 284 from 2 months in 2017. There was no significant difference in the proportion of patients undergoing WBCT (61.6% vs 59.5%), selective CT (31.9% vs 32.4%) or no CT (6.5% vs 8.1%) between the cohorts. There was no improvement in the rate of negative WBCT observed between 2013 and 2017 (47.6% vs 39.6%, p = 0.17).

Conclusion

There was no improvement in patient selection for WBCT following trauma at our institution over a three-year period. Optimal patient selection presents an ongoing clinical challenge, with 39–47% of patients undergoing a scan demonstrating no injuries.

Keywords

Blunt injury Nonpenetrating injury Trauma centre Whole-body imaging 

Notes

Compliance with ethical standards

Conflict of interest

P. Beak, B. Gabbott and M. Williamson declare that they have no conflict of interest to disclose. CB Hing reports personal fees from Elsevier, grants from ORUK, grants from Arthrex, grants from Stryker, grants from NIHR, outside the submitted work.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Trauma and OrthopaedicsSt George’s Hospital, St George’s University Hospitals NHS Foundation TrustLondonUK

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