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Journal of Trauma Management & Outcomes
Published in: Journal of Trauma Management & Outcomes 1/2010

Open Access 01-12-2010 | Research

Trauma management incorporating focused assessment with computed tomography in trauma (FACTT) - potential effect on survival

Authors: Karl-Georg Kanz, April O Paul, Rolf Lefering, Mike V Kay, Uwe Kreimeier, Ulrich Linsenmaier, Wolf Mutschler, Stefan Huber-Wagner, the Trauma Registry of the German Trauma Society

Published in: Journal of Trauma Management & Outcomes | Issue 1/2010

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Abstract

Background

Immediate recognition of life-threatening conditions and injuries is the key to trauma management. To date, the impact of focused assessment with computed tomography in trauma (FACTT) has not been formally assessed. We aimed to find out whether the concept of using FACTT during primary trauma survey has a negative or positive effect on survival.

Methods

In a retrospective, multicentre study, we compared our time management and probability of survival (Ps) in major trauma patients who received FACTT during trauma resuscitation with the trauma registry of the German Trauma Society (DGU). FACTT is defined as whole-body computed tomography (WBCT) during primary trauma survey. We determined the probability of survival according to the Trauma and Injury Severity Score (TRISS), the Revised Injury Severity Classification score (RISC) and the standardized mortality ratio (SMR).

Results

We analysed 4.817 patients from the DGU database from 2002 until 2004, 160 (3.3%) were from our trauma centre at the Ludwig-Maximilians-University (LMU) and 4.657 (96.7%) from the DGU group. 73.2% were male with a mean age of 42.5 years, a mean ISS of 29.8. 96.2% had suffered from blunt trauma. Time from admission to FAST (focused assessment with sonography for trauma)(4.3 vs. 8.7 min), chest x-ray (8.1 vs. 16.0 min) and whole-body CT (20.7 vs. 36.6 min) was shorter at the LMU compared to the other trauma centres (p < 0.001). SMR calculated by TRISS was 0.74 (CI95% 0.40-1.08) for the LMU (p = 0.24) and 0.92 (CI95% 0.84-1.01) for the DGU group (p = 0.10). RISC methodology revealed a SMR of 0.69 (95%CI 0.47-0.92) for the LMU (p = 0.043) and 1.00 (95%CI 0.94-1.06) for the DGU group (p = 0.88).

Conclusion

Trauma management incorporating FACTT enhances a rapid response to life-threatening problems and enables a comprehensive assessment of the severity of each relevant injury. Due to its speed and accuracy, FACTT during primary trauma survey supports rapid decision-making and may increase survival.
Appendix
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Metadata
Title
Trauma management incorporating focused assessment with computed tomography in trauma (FACTT) - potential effect on survival
Authors
Karl-Georg Kanz
April O Paul
Rolf Lefering
Mike V Kay
Uwe Kreimeier
Ulrich Linsenmaier
Wolf Mutschler
Stefan Huber-Wagner
the Trauma Registry of the German Trauma Society
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Journal of Trauma Management & Outcomes / Issue 1/2010
Electronic ISSN: 1752-2897
DOI
https://doi.org/10.1186/1752-2897-4-4

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