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The evolution of computed tomography from organ-selective to whole-body scanning in managing unconscious patients with multiple trauma: A retrospective cohort study

We aimed to evaluate the benefit of whole-body computed tomography (WBCT) scanning for unconscious adult patients suffering from high-energy multiple trauma compared with the conventional stepwise approach of organ-selective CT. Totally, 144 unconscious patients with high-energy multiple trauma from...

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Autores principales: Hong, Zhi-Jie, Chen, Cheng-Jueng, Yu, Jyh-Cherng, Chan, De-Chuan, Chou, Yu-Ching, Liang, Chia-Ming, Hsu, Sheng-Der
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402558/
https://www.ncbi.nlm.nih.gov/pubmed/27631215
http://dx.doi.org/10.1097/MD.0000000000004653
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author Hong, Zhi-Jie
Chen, Cheng-Jueng
Yu, Jyh-Cherng
Chan, De-Chuan
Chou, Yu-Ching
Liang, Chia-Ming
Hsu, Sheng-Der
author_facet Hong, Zhi-Jie
Chen, Cheng-Jueng
Yu, Jyh-Cherng
Chan, De-Chuan
Chou, Yu-Ching
Liang, Chia-Ming
Hsu, Sheng-Der
author_sort Hong, Zhi-Jie
collection PubMed
description We aimed to evaluate the benefit of whole-body computed tomography (WBCT) scanning for unconscious adult patients suffering from high-energy multiple trauma compared with the conventional stepwise approach of organ-selective CT. Totally, 144 unconscious patients with high-energy multiple trauma from single level I trauma center in North Taiwan were enrolled from January 2009 to December 2013. All patients were managed by a well-trained trauma team and were suitable for CT examination. The enrolled patients are all transferred directly from the scene of an accident, not from other medical institutions with a definitive diagnosis. The scanning regions of WBCT include head, neck, chest, abdomen, and pelvis. We analyzed differences between non-WBCT and WBCT groups, including gender, age, hospital stay, Injury Severity Score, Glasgow Coma Scale, Revised Trauma Score, time in emergency department (ED), medical cost, and survival outcome. Fifty-five patients received the conventional approach for treating trauma, and 89 patients received immediate WBCT scanning after an initial examination. Patients’ time in ED was significantly shorter in the WBCT group in comparison with the non-WBCT group (158.62 ± 80.13 vs 216.56 ± 168.32 min, P = 0.02). After adjusting for all possible confounding factors, we also found that survival outcome of the WBCT group was better than that of the non-WBCT group (odds ratio: 0.21, 95% confidence interval: 0.06–0.75, P = 0.016). Early performing WBCT during initial trauma management is a better approach for treating unconscious patients with high-energy multiple trauma.
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spelling pubmed-54025582017-04-27 The evolution of computed tomography from organ-selective to whole-body scanning in managing unconscious patients with multiple trauma: A retrospective cohort study Hong, Zhi-Jie Chen, Cheng-Jueng Yu, Jyh-Cherng Chan, De-Chuan Chou, Yu-Ching Liang, Chia-Ming Hsu, Sheng-Der Medicine (Baltimore) 3900 We aimed to evaluate the benefit of whole-body computed tomography (WBCT) scanning for unconscious adult patients suffering from high-energy multiple trauma compared with the conventional stepwise approach of organ-selective CT. Totally, 144 unconscious patients with high-energy multiple trauma from single level I trauma center in North Taiwan were enrolled from January 2009 to December 2013. All patients were managed by a well-trained trauma team and were suitable for CT examination. The enrolled patients are all transferred directly from the scene of an accident, not from other medical institutions with a definitive diagnosis. The scanning regions of WBCT include head, neck, chest, abdomen, and pelvis. We analyzed differences between non-WBCT and WBCT groups, including gender, age, hospital stay, Injury Severity Score, Glasgow Coma Scale, Revised Trauma Score, time in emergency department (ED), medical cost, and survival outcome. Fifty-five patients received the conventional approach for treating trauma, and 89 patients received immediate WBCT scanning after an initial examination. Patients’ time in ED was significantly shorter in the WBCT group in comparison with the non-WBCT group (158.62 ± 80.13 vs 216.56 ± 168.32 min, P = 0.02). After adjusting for all possible confounding factors, we also found that survival outcome of the WBCT group was better than that of the non-WBCT group (odds ratio: 0.21, 95% confidence interval: 0.06–0.75, P = 0.016). Early performing WBCT during initial trauma management is a better approach for treating unconscious patients with high-energy multiple trauma. Wolters Kluwer Health 2016-09-16 /pmc/articles/PMC5402558/ /pubmed/27631215 http://dx.doi.org/10.1097/MD.0000000000004653 Text en Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 3900
Hong, Zhi-Jie
Chen, Cheng-Jueng
Yu, Jyh-Cherng
Chan, De-Chuan
Chou, Yu-Ching
Liang, Chia-Ming
Hsu, Sheng-Der
The evolution of computed tomography from organ-selective to whole-body scanning in managing unconscious patients with multiple trauma: A retrospective cohort study
title The evolution of computed tomography from organ-selective to whole-body scanning in managing unconscious patients with multiple trauma: A retrospective cohort study
title_full The evolution of computed tomography from organ-selective to whole-body scanning in managing unconscious patients with multiple trauma: A retrospective cohort study
title_fullStr The evolution of computed tomography from organ-selective to whole-body scanning in managing unconscious patients with multiple trauma: A retrospective cohort study
title_full_unstemmed The evolution of computed tomography from organ-selective to whole-body scanning in managing unconscious patients with multiple trauma: A retrospective cohort study
title_short The evolution of computed tomography from organ-selective to whole-body scanning in managing unconscious patients with multiple trauma: A retrospective cohort study
title_sort evolution of computed tomography from organ-selective to whole-body scanning in managing unconscious patients with multiple trauma: a retrospective cohort study
topic 3900
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402558/
https://www.ncbi.nlm.nih.gov/pubmed/27631215
http://dx.doi.org/10.1097/MD.0000000000004653
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