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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 1/2017

Open Access 01-02-2017 | Review Article

Indications for total-body computed tomography in blunt trauma patients: a systematic review

Authors: K. Treskes, T. P. Saltzherr, J. S. K. Luitse, L. F. M. Beenen, J. C. Goslings

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2017

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Abstract

Purpose

Total-body CT scanning (TBCT) could improve the initial in-hospital evaluation of severe trauma patients. Indications for TBCT, however, differ between trauma centers, so more insight in how to select patients that could benefit from TBCT is required. The aim of this review was to give an overview of currently used indications for total-body CT in trauma patients and to describe mortality and Injury Severity Scores of patient groups selected for TBCT.

Methods

A systematic review was performed by searching MEDLINE and Embase databases. Studies evaluating or describing criteria for selection of patients with potentially severe injuries for TBCT during initial trauma care were included. Also, studies comparing total-body CT during the initial assessment of injured patients with conventional imaging and selective CT in specific patient groups were included.

Results

Thirty eligible studies were identified. Three studies evaluated indications for TBCT in trauma with divergent methods. Combinations of compromised vital parameters, severe trauma mechanisms and clinical suspicion on severe injuries are often used indications; however, clinical judgement is used as well. Studies describing TBCT indications selected patients in different ways and were difficult to compare regarding mortality and injury severity.

Conclusions

Indications for TBCT in trauma show a wide variety in structure and cut-off values for vital parameters and trauma mechanism dimensions. Consensus on indications for TBCT in trauma is lacking.
Appendix
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Literature
1.
American College of Surgeons Committee on Trauma: ATLS advanced trauma life support program for doctors. Chicago 2013.
2.
Huber-Wagner S, Lefering R, Qvick LM, Korner M, Kay MV, Pfeifer KJ, et al. Effect of whole-body CT during trauma resuscitation on survival: a retrospective, multicentre study. Lancet. 2009;373(9673):1455–61.CrossRefPubMed
3.
Asha S, Curtis KA, Grant N, Taylor C, Lo S, Smart R, et al. Comparison of radiation exposure of trauma patients from diagnostic radiology procedures before and after the introduction of a panscan protocol. Emerg Med Australas. 2012;24(1):43–51.CrossRefPubMed
4.
Sierink JC, Saltzherr TP, Wirtz MR, Streekstra GJ, Beenen LF, Goslings JC. Radiation exposure before and after the introduction of a dedicated total-body CT protocol in multitrauma patients. Emerg Radiol. 2013;20(6):507–12.CrossRefPubMed
5.
Stengel D, Frank M, Matthes G, Schmucker U, Seifert J, Mutze S, et al. Primary pan-computed tomography for blunt multiple trauma: can the whole be better than its parts? Injury. 2009;40(Suppl 4):S36–46.CrossRefPubMed
6.
Babaud J, Ridereau-Zins C, Bouhours G, Lebigot J, Le GR, Bertrais S, et al. Benefit of the Vittel criteria to determine the need for whole body scanning in a severe trauma patient. Diagn Interv Imaging. 2012;93(5):371–9.CrossRefPubMed
7.
Hsiao KH, Dinh MM, McNamara KP, Bein KJ, Roncal S, Saade C, et al. Whole-body computed tomography in the initial assessment of trauma patients: is there optimal criteria for patient selection? Emerg Med Australas. 2013;25(2):182–91.CrossRefPubMed
8.
Wurmb TE, Fruhwald P, Hopfner W, Roewer N, Brederlau J. Whole-body multislice computed tomography as the primary and sole diagnostic tool in patients with blunt trauma: searching for its appropriate indication. Am J Emerg Med. 2007;25(9):1057–62.CrossRefPubMed
9.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.CrossRefPubMedPubMedCentral
10.
Riou B, Thicoïpé M, Atain-Kouadio P, Carli P. Le traumatisé grave. Actualités en réanimation préhospitalière. Journées scientifiques des SAMU de France. 2002.
11.
Huber-Wagner S, Biberthaler P, Haberle S, Wierer M, Dobritz M, Rummeny E, et al. Whole-body CT in haemodynamically unstable severely injured patients–a retrospective, multicentre study. PLoS One. 2013;8(7):e68880.CrossRefPubMedPubMedCentral
12.
Prokop A, Hotte H, Kruger K, Rehm KE, Isenberg J, Schiffer G. Multislice CT in diagnostic work-up of polytrauma. Unfallchirurg. 2006;109(7):545–50.CrossRefPubMed
13.
Sedlic A, Chingkoe CM, Tso DK, Galea-Soler S, Nicolaou S. Rapid imaging protocol in trauma: a whole-body dual-source CT scan. Emerg Radiol. 2013;20(5):401–8.CrossRefPubMed
14.
Sierink JC, Saltzherr TP, Beenen LF, Russchen MJ, Luitse JS, Dijkgraaf MG, et al. A case-matched series of immediate total-body CT scanning versus the standard radiological work-up in trauma patients. World J Surg. 2014;38(4):795–802.CrossRefPubMed
15.
Weninger P, Mauritz W, Fridrich P, Spitaler R, Figl M, Kern B, et al. Emergency room management of patients with blunt major trauma: evaluation of the multislice computed tomography protocol exemplified by an urban trauma center. J Trauma. 2007;62(3):584–91.CrossRefPubMed
16.
Rieger M, Czermak B, El AR, Sumann G, Jaschke W, Freund M. Initial clinical experience with a 64-MDCT whole-body scanner in an emergency department: better time management and diagnostic quality? J Trauma. 2009;66(3):648–57.CrossRefPubMed
17.
Gupta M, Schriger DL, Hiatt JR, Cryer HG, Tillou A, Hoffman JR, et al. Selective use of computed tomography compared with routine whole body imaging in patients with blunt trauma. Ann Emerg Med. 2011;58(5):407–16.CrossRefPubMed
18.
Tillou A, Gupta M, Baraff LJ, Schriger DL, Hoffman JR, Hiatt JR, et al. Is the use of pan-computed tomography for blunt trauma justified? A prospective evaluation. J Trauma. 2009;67(4):779–87.CrossRefPubMed
19.
Salim A, Sangthong B, Martin M, Brown C, Plurad D, Demetriades D. Whole body imaging in blunt multisystem trauma patients without obvious signs of injury: results of a prospective study. Arch Surg. 2006;141(5):468–73.CrossRefPubMed
20.
Self ML, Blake AM, Whitley M, Nadalo L, Dunn E. The benefit of routine thoracic, abdominal, and pelvic computed tomography to evaluate trauma patients with closed head injuries. Am J Surg. 2003;186(6):609–13.CrossRefPubMed
21.
Wada D, Nakamori Y, Yamakawa K, Yoshikawa Y, Kiguchi T, Tasaki O, et al. Impact on survival of whole-body computed tomography before emergency bleeding control in patients with severe blunt trauma. Crit Care. 2013;17(4):R178.CrossRefPubMedPubMedCentral
22.
Kimura A, Tanaka N. Whole-body computed tomography is associated with decreased mortality in blunt trauma patients with moderate-to-severe consciousness disturbance: a multicenter, retrospective study. J Trauma Acute Care Surg. 2013;75(2):202–6.CrossRefPubMed
23.
Stengel D, Ottersbach C, Matthes G, Weigeldt M, Grundei S, Rademacher G, et al. Accuracy of single-pass whole-body computed tomography for detection of injuries in patients with major blunt trauma. CMAJ. 2012;184(8):869–76.CrossRefPubMedPubMedCentral
24.
Hutter M, Woltmann A, Hierholzer C, Gartner C, Buhren V, Stengel D. Association between a single-pass whole-body computed tomography policy and survival after blunt major trauma: a retrospective cohort study. Scand J Trauma Resusc Emerg Med. 2011;19:73.CrossRefPubMedPubMedCentral
25.
Smith CM, Woolrich-Burt L, Wellings R, Costa ML. Major trauma CT scanning: the experience of a regional trauma centre in the UK. Emerg Med J. 2011;28(5):378–82.CrossRefPubMed
26.
Wurmb TE, Quaisser C, Balling H, Kredel M, Muellenbach R, Kenn W, et al. Whole-body multislice computed tomography (MSCT) improves trauma care in patients requiring surgery after multiple trauma. Emerg Med J. 2011;28(4):300–4.CrossRefPubMed
27.
Smith CM, Mason S. The use of whole-body CT for trauma patients: survey of UK emergency departments. Emerg Med J. 2012;29(8):630–4.CrossRefPubMed
28.
Wurmb TE, Fruhwald P, Hopfner W, Keil T, Kredel M, Brederlau J, et al. Whole-body multislice computed tomography as the first line diagnostic tool in patients with multiple injuries: the focus on time. J Trauma. 2009;66(3):658–65.CrossRefPubMed
29.
Nguyen D, Platon A, Shanmuganathan K, Mirvis SE, Becker CD, Poletti PA. Evaluation of a single-pass continuous whole-body 16-MDCT protocol for patients with polytrauma. AJR Am J Roentgenol. 2009;192(1):3–10.CrossRefPubMed
30.
Sampson MA, Colquhoun KB, Hennessy NL. Computed tomography whole body imaging in multi-trauma: 7 years experience. Clin Radiol. 2006;61(4):365–9.CrossRefPubMed
31.
Wurmb T, Fruhwald P, Brederlau J, Steinhubel B, Frommer M, Kuhnigk H, et al. The Wurzburg polytrauma algorithm. Concept and first results of a sliding-gantry-based computer tomography diagnostic system. Anaesthesist. 2005;54(8):763–8.CrossRefPubMed
32.
Heyer CM, Rduch G, Kagel T, Lemburg SP, Theisinger A, Bauer TT, et al. Prospective randomized trial of a modified standard multislice CT protocol for the evaluation of multiple trauma patients. Rofo. 2005;177(2):242–9.CrossRefPubMed
33.
Albrecht T, von Schlippenbach J, Stahel PF, Ertel W, Wolf KJ. The role of whole body spiral CT in the primary work-up of polytrauma patients—comparison with conventional radiography and abdominal sonography. Rofo. 2004;176(8):1142–50.CrossRefPubMed
34.
Leidner B, Adiels M, Aspelin P, Gullstrand P, Wallen S. Standardized CT examination of the multitraumatized patient. Eur Radiol. 1998;8(9):1630–8.CrossRefPubMed
Metadata
Title
Indications for total-body computed tomography in blunt trauma patients: a systematic review
Authors
K. Treskes
T. P. Saltzherr
J. S. K. Luitse
L. F. M. Beenen
J. C. Goslings
Publication date
01-02-2017
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 1/2017
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-016-0711-4

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