Whole-body CT indications in emergency medicine trauma patients.


Ozcete E. , Uz I., Arslan B., Yalcinli S., Altunci Y. A.

Nigerian journal of clinical practice, vol.25, no.4, pp.496-501, 2022 (Journal Indexed in SCI Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 25 Issue: 4
  • Publication Date: 2022
  • Doi Number: 10.4103/njcp.njcp_1727_21
  • Title of Journal : Nigerian journal of clinical practice
  • Page Numbers: pp.496-501

Abstract

Background: Whole‑body computerized tomography (CT) scan designed as early

diagnosis of traumatic injuries and prevention of unnoticeable injuries. Using

Whole‑body CT in trauma patients still controversial, there is no consensus on

indications. Aims: The aim of this study is to clarify indications and cut‑off levels

in vital parameters in trauma patients who undergo Whole‑body CT to prevent

unnecessary or negative scans. Patients and Methods: We evaluated patients with

trauma who applied our emergency service between 01.09.2019 and 30.09.2020.

Patients above 18 years old with Whole‑body CT scan included. Whole‑body CT

reports were evaluated according to five categories; cranial‑face, vertebra, thorax,

abdomen, pelvis‑bone. Results: The review of whole‑body CT reports, 46.3%

detected normally. But, 53.7% of patients had injuries at least one zone, 23.3%

at least two zones, and 7.4% at least three zones respectively. Prediction criteria

of Whole‑body CT for the patients with two or three zones injury, systolic blood

pressure (SBP) ≤100 mm Hg, Glasgow coma scale (GCS) <15, and free fluid

in Focused Assessment with Sonography for Trauma (FAST) were independent

variables in regression analysis. When patients had at least one of three variables,

the negative predictive value of whole‑body CT was 96% for three zones and 91%

for two zones. Conclusion: The cut‑off values of GCS <15 and SBP ≤100 mm Hg

were useful vital parameters in making whole‑body CT decisions in trauma

patients in the emergency service. Also, free fluid detection in FAST can be used

for whole‑body CT decisions.