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European Journal of Orthopaedic Surgery & Traumatology

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01-04-2020 | Original Article • TRAUMA - SCANNER

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

Authors: Philip Beak, Ben Gabbott, Michael Williamson, Caroline B. Hing

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 3/2020

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.

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Title: Four years of experience as a major trauma centre results in no improvement in patient selection for whole-body CT scans following blunt trauma
Authors: Philip Beak
Ben Gabbott
Michael Williamson
Caroline B. Hing
Publication date: 01-04-2020
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 3/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-019-02592-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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