Correlation of CT findings remote from prime area of interest: a multitrauma study

BACKGROUND: Multitrauma patients represent a difficult cohort of patients from a diagnostic standpoint. Current trauma recommendations do not advise whole-body computed tomography (CT) in hemodynamically stable patients. OBJECTIVE: To measure the prevalence of abnormal CT findings in areas other than the prime area of clinical interest in multitrauma patients. METHOD: The records of 462 consecutive adult patients who underwent whole-body CT scans between 2004 and 2005 at Westmead Hospital, a Level 1 trauma center, were assessed. Clinical parameters, including suspected clinical injury, regional tenderness, bruising, loss of consciousness, scalp laceration, and unequal chest air entry, were examined. Correlation was made with CTs performed from the brain to symphysis pubis, on a Toshiba 16 slice machine, with evaluation of clinically significant findings. RESULTS: The prevalence of abnormal CT findings distant to the prime area of concern varied between anatomical areas: brain (10.3%–88.7%), skull (6.7%–39.7%), facial bones (4.4%–54.3%), cervical spine (5.6%–13.7%), thoracolumbar spine (5.6%–26.7%), chest (30.8%–54.4%), and abdomen/pelvis (20%–27.2%). CONCLUSION: There is a high prevalence of injuries remote from the prime area of clinical concern in multitrauma patients. Whole-body CT is a rapid, accurate, and systematic imaging modality that provides an early, complete, clinical picture for the treating physician.