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17-06-2024 | Computed Tomography | Original Article

Comparison of whole body computed tomography findings with physician predictions in high-energy blunt trauma patients: prospective observational study

Authors: Sedat Akkan, Ömür Uyanik, Muhammet Ceyhan, Fatma Nur Karaarslan

Published in: European Journal of Trauma and Emergency Surgery

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Abstract

Background

The whole-body computed tomography (WBCT) procedure is increasingly common in evaluating patients presenting with high-energy trauma. However, it remains unclear in which population WBCT provides benefit and whether its routine application is truly beneficial. In this study, we aimed to compare physician predictions with WBCT findings in patients with high-energy blunt trauma.

Methods

The study was conducted as a single-center prospective observational study at a tertiary center. Patients presenting with high-energy blunt trauma between 01.03.2021–01.03.2023 were included. Both physician predictions and WBCT findings were recorded and compared in three categories: "no pathology," "no life-threatening pathology," and "life-threatening pathology." The predictive values of physician predictions for each category were calculated. The characteristics of patients evaluated as less severe than predicted by clinicians were examined.

Results

The study included a total of 92 patients. The median age was 27 years (IQR 25–75; 20–54). Among the patients, 27 (%) had life-threatening injuries according to CT findings in any region. A total of 34 (37%) patients were predicted by physicians to have "no pathology" in all three regions. Among these patients, none had life-threatening pathology in all three regions. There were 10 (10.9%) patients with CT findings more severe than physician predictions in at least one region. The sensitivity of physician predictions for life-threatening injury to the head/cervical region was 94.1% (95% CI: 71.3–99.9). For life-threatening injury to the chest, the sensitivity was 85.7% (95% CI: 42.1–99.6). For the presence of life-threatening abdominal pathology, the sensitivity was 100% (95% CI: 63.1–100).

Conclusıon

It appears reasonable to utilize WBCT in patients where physicians expect life-threatening injury in any system. However, in cases where no pathology is expected in any system according to clinical prediction, we believe that performing WBCT solely based on trauma mechanism will not provide sufficient benefit.
Literature
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Metadata
Title
Comparison of whole body computed tomography findings with physician predictions in high-energy blunt trauma patients: prospective observational study
Authors
Sedat Akkan
Ömür Uyanik
Muhammet Ceyhan
Fatma Nur Karaarslan
Publication date
17-06-2024
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-024-02564-1