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Open Access 01-06-2012 | Research

Impact of whole-body computed tomography on mortality and surgical management of severe blunt trauma

Authors: Jean-Michel Yeguiayan, Anabelle Yap, Marc Freysz, Delphine Garrigue, Claude Jacquot, Claude Martin, Christine Binquet, Bruno Riou, Claire Bonithon-Kopp, the FIRST Study Group

Published in: Critical Care | Issue 3/2012

Abstract

Introduction

The mortality benefit of whole-body computed tomography (CT) in early trauma management remains controversial and poorly understood. The objective of this study was to assess the impact of whole-body CT compared with selective CT on mortality and management of patients with severe blunt trauma.

Methods

The FIRST (French Intensive care Recorded in Severe Trauma) study is a multicenter cohort study on consecutive patients with severe blunt trauma requiring admission to intensive care units from university hospital trauma centers within the first 72 hours. Initial data were combined to construct a propensity score to receive whole-body CT and selective CT used in multivariable logistic regression models, and to calculate the probability of survival according to the Trauma and Injury Severity Score (TRISS) for 1,950 patients. The main endpoint was 30-day mortality.

Results

In total, 1,696 patients out of 1,950 (87%) were given whole-body CT. The crude 30-day mortality rates were 16% among whole-body CT patients and 22% among selective CT patients (p = 0.02). A significant reduction in the mortality risk was observed among whole-body CT patients whatever the adjustment method (OR = 0.58, 95% CI: 0.34-0.99 after adjustment for baseline characteristics and post-CT treatment). Compared to the TRISS predicted survival, survival significantly improved for whole-body CT patients but not for selective CT patients. The pattern of early surgical and medical procedures significantly differed between the two groups.

Conclusions

Diagnostic whole-body CT was associated with a significant reduction in 30-day mortality among patients with severe blunt trauma. Its use may be a global indicator of better management.

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Title: Impact of whole-body computed tomography on mortality and surgical management of severe blunt trauma
Authors: Jean-Michel Yeguiayan
Anabelle Yap
Marc Freysz
Delphine Garrigue
Claude Jacquot
Claude Martin
Christine Binquet
Bruno Riou
Claire Bonithon-Kopp
the FIRST Study Group
Publication date: 01-06-2012
Publisher: BioMed Central
Published in: Critical Care / Issue 3/2012
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc11375

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of whole-body computed tomography on mortality and surgical management of severe blunt trauma

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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