Four years of experience as a major trauma centre results in no improvement in patient selection for whole-body CT scans following blunt trauma
| Autor: | Michael Williamson, Philip Beak, Ben Gabbott, Caroline B. Hing |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Whole body imaging Whole body ct Unnecessary Procedures Wounds Nonpenetrating 030218 nuclear medicine & medical imaging 03 medical and health sciences Young Adult 0302 clinical medicine Trauma Centers medicine Humans Orthopedics and Sports Medicine In patient Whole Body Imaging Aged Retrospective Studies Aged 80 and over business.industry Major trauma Significant difference 030208 emergency & critical care medicine Retrospective cohort study Middle Aged medicine.disease Polytrauma Quality Improvement Blunt trauma Surgery Female Radiology business Tomography X-Ray Computed |
| Zdroj: | European journal of orthopaedic surgerytraumatology : orthopedie traumatologie. 30(3) |
| ISSN: | 1432-1068 |
| Popis: | 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). 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. 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). 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. |
| Databáze: | OpenAIRE |
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