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A Case-matched Series of Immediate Total-body CT Scanning Versus the Standard Radiological Work-up in Trauma Patients

Published on Apr 1, 2014in World Journal of Surgery2.77
· DOI :10.1007/s00268-013-2310-4
Joanne C. Sierink9
Estimated H-index: 9
(AMC: Academic Medical Center),
Teun Peter Saltzherr13
Estimated H-index: 13
(AMC: Academic Medical Center)
+ 4 AuthorsJ. Carel Goslings24
Estimated H-index: 24
(AMC: Academic Medical Center)
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Abstract
Background In recent years computed tomography (CT) has become faster and more available in the acute trauma care setting. The aim of the present study was to compare injured patients who underwent immediate total-body CT (TBCT) scanning with patients who underwent the standard radiological work-up with respect to 30-day mortality.
  • References (32)
  • Citations (20)
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References32
Newest
Published on Apr 1, 2013in Emergency Medicine Australasia1.50
Kai Hsun Hsiao1
Estimated H-index: 1
(RPA: Royal Prince Alfred Hospital),
Michael M Dinh12
Estimated H-index: 12
(RPA: Royal Prince Alfred Hospital)
+ 5 AuthorsKee Fung Chi2
Estimated H-index: 2
(RPA: Royal Prince Alfred Hospital)
Objective To describe the use of whole-body computed tomography (WBCT) at this Major Trauma Centre; to determine independent predictors of multi-region injury; and to evaluate the accuracy of the decision to perform WBCT in detecting multi-region injury. Methods A prospective cohort study was performed at a single Major Trauma Centre in New South Wales, Australia. All adult patients who triggered trauma team activation and required an initial CT scan were studied. Primary outcome was the presenc...
Published on Jan 1, 2012in British Journal of Surgery5.59
Teun Peter Saltzherr13
Estimated H-index: 13
,
Fred C. Bakker18
Estimated H-index: 18
(VU: VU University Amsterdam)
+ 3 AuthorsJ. C. Goslings16
Estimated H-index: 16
Background: Computed tomography (CT) of injured patients in the radiology department requires potentially dangerous and time-consuming patient transports and transfers. It was hypothesized that CT in the trauma room would improve patient outcome and workflow. Methods: A randomized trial compared the effect of locating a CT scanner in the trauma room versus the radiology department in two Dutch trauma hospitals. Injured patients aged at least 16 years were assigned randomly to one of these hospit...
Published on Jan 1, 2012in British Journal of Surgery5.59
Joanne C. Sierink9
Estimated H-index: 9
,
Teun Peter Saltzherr13
Estimated H-index: 13
+ 3 AuthorsJ. C. Goslings16
Estimated H-index: 16
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 select...
Published on Jan 1, 2012in Critical Care6.96
Jean Michel Yeguiayan3
Estimated H-index: 3
(University of Burgundy),
Anabelle Yap1
Estimated H-index: 1
+ 6 AuthorsClaire Bonithon-Kopp38
Estimated H-index: 38
(French Institute of Health and Medical Research)
Introduction: The mortality benefit of whole-body computed tomography (CT) in early trauma management remains controversial and poorly understood. The objective of this study was to assess the impact of whole-body CT compared with selective CT on mortality and management of patients with severe blunt trauma. Methods: The FIRST (French Intensive care Recorded in Severe Trauma) study is a multicenter cohort study on consecutive patients with severe blunt trauma requiring admission to intensive car...
Published on Apr 1, 2011in Emergency Medicine Journal2.31
T. Wurmb15
Estimated H-index: 15
,
C Quaisser1
Estimated H-index: 1
+ 5 AuthorsJ Brederlau1
Estimated H-index: 1
Objectives Whole-body multislice helical CT becomes increasingly important as a diagnostic tool in patients with multiple injuries. Time gain in multiple-trauma patients who require emergency surgery might improve outcome. The authors hypothesised that whole-body multislice computed tomography (MSCT) (MSCT trauma protocol) as the initial diagnostic tool reduces the interval to start emergency surgery (tOR) if compared to conventional radiography, combined with abdominal ultrasound and organ-focu...
R. van Vugt2
Estimated H-index: 2
(Radboud University Nijmegen),
Jaap Deunk11
Estimated H-index: 11
(Radboud University Nijmegen)
+ 4 AuthorsM.J.R. Edwards9
Estimated H-index: 9
(Radboud University Nijmegen)
Introduction Many scoring systems have been proposed to predict the survival of trauma patients. This study was performed to evaluate the influence of routine thoracoabdominal computed tomography (CT) on the predicted survival according to the trauma injury severity score (TRISS).
Martin Hutter2
Estimated H-index: 2
,
Alexander Woltmann7
Estimated H-index: 7
+ 3 AuthorsDirk Stengel23
Estimated H-index: 23
Introduction Single-pass, whole-body computed tomography (pan-scan) remains a controversial intervention in the early assessment of patients with major trauma. We hypothesized that a liberal pan-scan policy is mainly an indicator of enhanced process quality of emergency care that may lead to improved survival regardless of the actual use of the method.
Jaap Deunk11
Estimated H-index: 11
,
Tielke C. Poels1
Estimated H-index: 1
+ 5 AuthorsMichael J. R. Edwards9
Estimated H-index: 9
BACKGROUND: Multidetector-row computed tomography (MDCT) is a more sensitive modality as compared with conventional radiography (CR) in detecting pulmonary injuries. MDCT often detects pulmonary contusion that is not visualized by CR, defined as occult pulmonary contusion (OPC). The aim of this study was to investigate whether OPC on MDCT has implications for the outcome in blunt trauma patients. METHODS: We used prospectively collected data from 1,040 adult high-energy blunt trauma patients who...
Published on Oct 1, 2009in European Journal of Radiology2.95
P.H.P. Fung Kon Jin5
Estimated H-index: 5
,
A.R. van Geene1
Estimated H-index: 1
(Harborview Medical Center)
+ 3 AuthorsJ. C. Goslings16
Estimated H-index: 16
Abstract Introduction While computed tomography (CT) scan usage in acute trauma patients is currently part of the standard complete diagnostic workup, little is known regarding the time factors involved when CT scanning is added to the standard workup. An analysis of the current time factors and intervals in a high-volume, streamlined level-1 trauma center can potentially expose points of improvement in the trauma resuscitation phase. Materials and methods During a 5-week period, data on current...
Published on Apr 1, 2009in The Lancet59.10
Stefan Huber-Wagner16
Estimated H-index: 16
(LMU: Ludwig Maximilian University of Munich),
Rolf Lefering52
Estimated H-index: 52
+ 6 AuthorsKarl-Georg Kanz25
Estimated H-index: 25
(LMU: Ludwig Maximilian University of Munich)
Summary Background The number of trauma centres using whole-body CT for early assessment of primary trauma is increasing. There is no evidence to suggest that use of whole-body CT has any effect on the outcome of patients with major trauma. We therefore compared the probability of survival in patients with blunt trauma who had whole-body CT during resuscitation with those who had not. Methods In a retrospective, multicentre study, we used the data recorded in the trauma registry of the German Tr...
Cited By20
Newest
Yusuke Tsutsumi2
Estimated H-index: 2
(Kyoto University),
Shingo Fukuma8
Estimated H-index: 8
(Kyoto University)
+ 5 AuthorsShunichi Fukuhara55
Estimated H-index: 55
(Kyoto University)
Background Although many hemodynamically unstable trauma patients undergo computed tomography (CT) to identify a source of bleeding, this practice is currently only recommended by a few guidelines. To clarify whether CT has harmful effects among these patients, we examined the association between CT during initial management and mortality among unstable blunt trauma patients.
Swathikan Chidambaram3
Estimated H-index: 3
(St Mary's Hospital),
En Lin Goh3
Estimated H-index: 3
(St Mary's Hospital),
Mansoor Khan9
Estimated H-index: 9
(St Mary's Hospital)
Abstract Background Traumatic injury is the third leading cause of death overall. To optimize the outcomes in these patients, hospitals employ whole-body computed tomography (WBCT) imaging due to the high diagnostic yield and potential to identify missed injuries. However, this delays time-critical interventions. Currently, there is an absence of any high-level evidence to support or refute either view. We present a meta-analysis of the available literature to elucidate the efficacy of WBCT in i...
Published on Feb 1, 2017in Langenbeck's Archives of Surgery2.09
Georgios F. Giannakopoulos9
Estimated H-index: 9
(VU: VU University Amsterdam),
Teun Peter Saltzherr13
Estimated H-index: 13
+ 5 AuthorsFred C. Bakker18
Estimated H-index: 18
(VU: VU University Amsterdam)
Background During the initial assessment of patients with potential severe injuries, radiological examinations are performed in order to rapidly diagnose clinically relevant injuries. Previous studies have shown that performing these examinations routinely is not always necessary and that trauma patients are exposed to substantial radiation doses. The aim of this study was to assess the amount and findings of radiological examinations during the initial assessment of trauma patients and to deter...
K. Treskes3
Estimated H-index: 3
(AMC: Academic Medical Center),
Teun Peter Saltzherr13
Estimated H-index: 13
(AMC: Academic Medical Center)
+ 2 AuthorsJ. C. Goslings6
Estimated H-index: 6
(AMC: Academic Medical Center)
Purpose Total-body CT scanning (TBCT) could improve the initial in-hospital evaluation of severe trauma patients. Indications for TBCT, however, differ between trauma centers, so more insight in how to select patients that could benefit from TBCT is required. The aim of this review was to give an overview of currently used indications for total-body CT in trauma patients and to describe mortality and Injury Severity Scores of patient groups selected for TBCT.
Alistair Sharples1
Estimated H-index: 1
(QMUL: Queen Mary University of London),
Karim Brohi46
Estimated H-index: 46
(QMUL: Queen Mary University of London)
Abstract Introduction Blunt abdominal trauma is a common reason for admission to the Emergency Department. Early detection of injuries is an important goal but is often not straightforward as physical examination alone is not a good predictor of serious injury. Computed tomography (CT) has become the primary method for assessing the stable trauma patient. It has high sensitivity and specificity but there remains concern regarding the long term consequences of high doses of radiation. Therefore a...
Published on Jul 1, 2016in Seminars in Roentgenology0.65
Michael O’Keeffe1
Estimated H-index: 1
(UBC: University of British Columbia),
Sheldon Clark1
Estimated H-index: 1
(UBC: University of British Columbia)
+ 3 AuthorsSavvas Nicolaou27
Estimated H-index: 27
(UBC: University of British Columbia)
Published on May 1, 2016in British Journal of Radiology1.94
Fabian G Mueck7
Estimated H-index: 7
,
K. Wirth2
Estimated H-index: 2
+ 5 AuthorsStefan Wirth21
Estimated H-index: 21
Objective:The aim of the study was to analyse and interpret radiological mass casualty incident workflow data.Methods:In a mid-scale mass casualty incident exercise, the on-site triage assigned 12 cases to the investigated institution (11 included in the study). Two out of five institutional multislice-CT-scanners were used and the whole CT workflow and radiological service process chain were simulated as close to realistic as possible. The respective time intervals for reaching defined mileston...
Van K. Holden2
Estimated H-index: 2
(University of Maryland Medical Center),
Nirav G. Shah10
Estimated H-index: 10
(University of Maryland Medical Center),
Avelino C. Verceles10
Estimated H-index: 10
(University of Maryland Medical Center)
Introduction. Pulmonary arteriovenous malformations (PAVMs) have been associated with life-threatening complications, such as stroke and massive hemoptysis, thus posing significant morbidity if left untreated. We report a case of an incidental finding of a PAVM in a trauma patient newly recognized to have suspected hereditary hemorrhagic telangiectasia (HHT). Case Description. A 34-year-old man with a history of recurrent epistaxis presented with a sudden fall associated with seizure-like activi...
Ronnie M. Davies1
Estimated H-index: 1
,
Ashley Scrimshire2
Estimated H-index: 2
+ 2 AuthorsE. Martin Holt1
Estimated H-index: 1
Abstract Background Whole-body CT (WBCT) has become routine practice in the assessment of major trauma patients. Whilst this may be associated with increased survival, several studies report high rates of negative scans. As no national guideline exists, selection criteria for WBCT vary widely. This study aims to (1) produce a scoring system that improves patient selection for WBCT (2) quantify patient radiation doses and their concomitant risk of malignancy. Methods Clinical notes were reviewed ...