Early CT scanning in the emergency department in patients with penetrating injuries: does it affect outcome?
| Autor: | R. Hoencamp, W. J. van den Hout, G.M. Van Der Wilden, F. Boot, F. J. Idenburg, S.J. Rhemrev |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male CT scan medicine.medical_specialty Sports medicine Computed tomography Wounds Stab Penetrating injury Critical Care and Intensive Care Medicine Trauma 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences Injury Severity Score 0302 clinical medicine Trauma Centers law medicine Humans Orthopedics and Sports Medicine In patient Registries Diagnostics Netherlands Retrospective Studies medicine.diagnostic_test business.industry Trauma center 030208 emergency & critical care medicine Emergency department Revised Trauma Score Intensive care unit Emergency Medicine Female Wounds Gunshot Original Article Surgery Radiology Emergency Service Hospital Tomography X-Ray Computed business |
| Zdroj: | European Journal of Trauma and Emergency Surgery |
| ISSN: | 1863-9941 1863-9933 |
| Popis: | Background To be a level I trauma center in the Netherlands a computed tomography (CT) scanner in the emergency department (ED) is considered desirable, as it is presumed that this optimizes the diagnostic process and that therapy can be directed based on these findings. Aim of this study was to assess the effects of implementing a CT scanner in the ED on outcomes in patients with penetrating injuries. Methods In this retrospective descriptive study, patients with penetrating injuries (shot and/or stab wounds), presented between 2000 and 2014 were analysed using the hospital’s electronic database, and data from the West Netherlands trauma registry and the financial department. Results 405 patients were included: performing a CT scan upon arrival increased significantly from 26.7 to 67.0% (p = 0.00) after implementation of a CT scanner in the ED, with the mean cost of a CT being 96.85 euros. Overall mortality decreased from 6.9 to 3.7%, although not statistically significant. Intensive care unit admission (ICU-admission) and median hospital length of stay (H-LOS) decreased from 30.9 to 24.5% resp. 3.2 to 1.8 days (p ≤ 0.05). Overall mortality, adjusted for injury severity score (ISS), revised trauma score (RTS), and types of injuries, did not change significantly. Conclusion Patients with penetrating injuries more often received a CT scan on admission after implementation of a CT scanner in the ED. Early CT scanning is useful since it significantly reduces ICU-admissions and decreases H-LOS. It is a cheap and non-invasive diagnostic tool with significant clinical impact, resulting in directed treatment, and improvement of outcomes. |
| Databáze: | OpenAIRE |
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