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ICU patients with infectious complications after abdominopelvic surgery: Is thoracic CT in addition to abdominal CT helpful?

BACKGROUND: The aim of this study was to assess the usefulness of adding thoracic CT to abdominal CT in intensive care unit (ICU) patients with signs of infection after abdominopelvic surgery. METHODS: 143 thoracoabdominal CTs of ICU patients with signs of infection after abdominopelvic surgery were...

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Autores principales: Nebelung, Heiner, Wotschel, Natalie, Held, Hanns-Christoph, Kirchberg, Johanna, Weitz, Jürgen, Radosa, Christoph Georg, Laniado, Michael, Hoffmann, Ralf-Thorsten, Plodeck, Verena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918641/
https://www.ncbi.nlm.nih.gov/pubmed/36763198
http://dx.doi.org/10.1186/s13613-023-01104-1
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author Nebelung, Heiner
Wotschel, Natalie
Held, Hanns-Christoph
Kirchberg, Johanna
Weitz, Jürgen
Radosa, Christoph Georg
Laniado, Michael
Hoffmann, Ralf-Thorsten
Plodeck, Verena
author_facet Nebelung, Heiner
Wotschel, Natalie
Held, Hanns-Christoph
Kirchberg, Johanna
Weitz, Jürgen
Radosa, Christoph Georg
Laniado, Michael
Hoffmann, Ralf-Thorsten
Plodeck, Verena
author_sort Nebelung, Heiner
collection PubMed
description BACKGROUND: The aim of this study was to assess the usefulness of adding thoracic CT to abdominal CT in intensive care unit (ICU) patients with signs of infection after abdominopelvic surgery. METHODS: 143 thoracoabdominal CTs of ICU patients with signs of infection after abdominopelvic surgery were retrospectively reviewed for thoracic pathologies. It was determined if pathologic findings were visible only on thoracic CT above the diaphragmatic dome or also on abdominal CT up to the diaphragmatic dome. All thoracic pathologies visible only above the diaphragmatic dome were retrospectively analyzed by an ICU physician in terms of clinical relevance. Diagnostic and therapeutic efficacy of thoracic CT were assessed with regard to an infectious focus and to other pathologic findings. RESULTS: 297 pathologic thoracic findings were recorded. 26 of the 297 findings could only be detected on images obtained above the diaphragmatic dome (in 23 of 143 CTs). A change in patient management was initiated due to only one of the 26 supradiaphragmatic findings. Diagnostic efficacy of thoracic CT in addition to abdominal CT to identify an infectious focus was 3.5% (95%-CI: 0.5–6.5%) and therapeutic efficacy was 0.7% (95%-CI: 0–2.1%). With regard to all pathologic thoracic findings, diagnostic efficacy was 16.1% (95%-CI: 10.1–22.1%) and therapeutic efficacy remained at 0.7%. CONCLUSIONS: Additional thoracic CT to detect an infectious focus in ICU patients after abdominopelvic surgery leads to identification of the focus in only 3.5% and to changes in patient management in only 0.7%. Other relevant findings are more common (16.1%), but very rarely affect patient management.
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spelling pubmed-99186412023-02-12 ICU patients with infectious complications after abdominopelvic surgery: Is thoracic CT in addition to abdominal CT helpful? Nebelung, Heiner Wotschel, Natalie Held, Hanns-Christoph Kirchberg, Johanna Weitz, Jürgen Radosa, Christoph Georg Laniado, Michael Hoffmann, Ralf-Thorsten Plodeck, Verena Ann Intensive Care Research BACKGROUND: The aim of this study was to assess the usefulness of adding thoracic CT to abdominal CT in intensive care unit (ICU) patients with signs of infection after abdominopelvic surgery. METHODS: 143 thoracoabdominal CTs of ICU patients with signs of infection after abdominopelvic surgery were retrospectively reviewed for thoracic pathologies. It was determined if pathologic findings were visible only on thoracic CT above the diaphragmatic dome or also on abdominal CT up to the diaphragmatic dome. All thoracic pathologies visible only above the diaphragmatic dome were retrospectively analyzed by an ICU physician in terms of clinical relevance. Diagnostic and therapeutic efficacy of thoracic CT were assessed with regard to an infectious focus and to other pathologic findings. RESULTS: 297 pathologic thoracic findings were recorded. 26 of the 297 findings could only be detected on images obtained above the diaphragmatic dome (in 23 of 143 CTs). A change in patient management was initiated due to only one of the 26 supradiaphragmatic findings. Diagnostic efficacy of thoracic CT in addition to abdominal CT to identify an infectious focus was 3.5% (95%-CI: 0.5–6.5%) and therapeutic efficacy was 0.7% (95%-CI: 0–2.1%). With regard to all pathologic thoracic findings, diagnostic efficacy was 16.1% (95%-CI: 10.1–22.1%) and therapeutic efficacy remained at 0.7%. CONCLUSIONS: Additional thoracic CT to detect an infectious focus in ICU patients after abdominopelvic surgery leads to identification of the focus in only 3.5% and to changes in patient management in only 0.7%. Other relevant findings are more common (16.1%), but very rarely affect patient management. Springer International Publishing 2023-02-10 /pmc/articles/PMC9918641/ /pubmed/36763198 http://dx.doi.org/10.1186/s13613-023-01104-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Nebelung, Heiner
Wotschel, Natalie
Held, Hanns-Christoph
Kirchberg, Johanna
Weitz, Jürgen
Radosa, Christoph Georg
Laniado, Michael
Hoffmann, Ralf-Thorsten
Plodeck, Verena
ICU patients with infectious complications after abdominopelvic surgery: Is thoracic CT in addition to abdominal CT helpful?
title ICU patients with infectious complications after abdominopelvic surgery: Is thoracic CT in addition to abdominal CT helpful?
title_full ICU patients with infectious complications after abdominopelvic surgery: Is thoracic CT in addition to abdominal CT helpful?
title_fullStr ICU patients with infectious complications after abdominopelvic surgery: Is thoracic CT in addition to abdominal CT helpful?
title_full_unstemmed ICU patients with infectious complications after abdominopelvic surgery: Is thoracic CT in addition to abdominal CT helpful?
title_short ICU patients with infectious complications after abdominopelvic surgery: Is thoracic CT in addition to abdominal CT helpful?
title_sort icu patients with infectious complications after abdominopelvic surgery: is thoracic ct in addition to abdominal ct helpful?
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918641/
https://www.ncbi.nlm.nih.gov/pubmed/36763198
http://dx.doi.org/10.1186/s13613-023-01104-1
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