Match!

Systematic review and meta-analysis of immediate total-body computed tomography compared with selective radiological imaging of injured patients.

Published on Jan 1, 2012in British Journal of Surgery5.59
· DOI :10.1002/bjs.7760
Joanne C. Sierink9
Estimated H-index: 9
,
Teun Peter Saltzherr13
Estimated H-index: 13
+ 3 AuthorsJ. C. Goslings16
Estimated H-index: 16
Cite
Abstract
Background: The aim of this review was to assess the value of immediate total-body computed tomography (CT) during the primary survey of injured patients compared with conventional radiographic imaging supplemented with selective CT. Methods: A systematic search of the literature was performed in MEDLINE, Embase, Web of Science and Cochrane Library databases. Reports were eligible if they contained original data comparing immediate total-body CT with conventional imaging supplemented with selective CT in injured patients. The main outcomes of interest were overall mortality and time in the emergency room (ER). Results: Four studies were included describing a total of 5470 patients; one study provided 4621 patients (84.5 per cent). All four studies were non-randomized cohort studies with retrospective data collection. Mortality was reported in three studies. Absolute mortality rates differed substantially between studies, but within studies mortality rates were comparable between immediate total-body CT and conventional imaging strategies (pooled odds ratio 0.91, 95 per cent confidence interval 0.79 to 1.05). Time in the ER was described in three studies, and in two was significantly shorter in patients who underwent immediate total-body CT: 70 versus 104 min (P = 0.025) and 47 versus 82 min (P <0.001) respectively. Conclusion: This review showed differences in time in the ER in favour of immediate total-body CT during the primary trauma survey compared with conventional radiographic imaging supplemented with selective CT. There were no differences in mortality. The substantial reduction in time in the ER is a promising feature of immediate total-body CT but well designed and larger randomized studies are needed to see how this will translate into clinical outcomes
  • References (34)
  • Citations (60)
Cite
References34
Newest
#1George Wells (U of O: University of Ottawa)H-Index: 11
#2B. SheaH-Index: 19
Last.J PetersenH-Index: 1
view all 10 authors...
#1David Moher (Ottawa Hospital Research Institute)H-Index: 126
#2Alessandro Liberati (Cochrane Collaboration)H-Index: 44
Last.Douglas G. Altman (University of Oxford)H-Index: 208
view all 4 authors...
#1Stefan Huber-Wagner (LMU: Ludwig Maximilian University of Munich)H-Index: 16
#2Rolf LeferingH-Index: 52
Last.K.-G. Kanz (LMU: Ludwig Maximilian University of Munich)H-Index: 10
view all 4 authors...
#1Stefan Huber-Wagner (LMU: Ludwig Maximilian University of Munich)H-Index: 16
#2Rolf LeferingH-Index: 52
Last.Karl-Georg Kanz (LMU: Ludwig Maximilian University of Munich)H-Index: 25
view all 9 authors...
Cited By60
Newest
#1Cassandra Jeavons (Royal Brisbane and Women's Hospital)H-Index: 1
#2Craig Hacking (Royal Brisbane and Women's Hospital)H-Index: 3
Last.Martin L. Gunn (UW: University of Washington)H-Index: 14
view all 4 authors...
#1Vittorio MieleH-Index: 16
#2Gloria AddeoH-Index: 1
Last.Roberto Grassi (Seconda Università degli Studi di Napoli)H-Index: 29
view all 7 authors...
#1Laura B. Eisenmenger (UofU: University of Utah)H-Index: 5
#2Booth Aldred (UofU: University of Utah)H-Index: 2
Last.Marta E. Heilbrun (Emory University)
view all 3 authors...
#1Thomas Geeraerts (University of Toulouse)H-Index: 14
#2Lionel Velly (AMU: Aix-Marseille University)H-Index: 16
Last.F. CottonH-Index: 25
view all 10 authors...
View next paperA multicenter, randomized controlled trial of immediate total-body CT scanning in trauma patients (REACT-2)