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Systematic review and meta-analysis of routine total body CT compared with selective CT in trauma patients

Published on Feb 1, 2014in Emergency Medicine Journal2.307
· DOI :10.1136/emermed-2012-201892
Donagh Healy15
Estimated H-index: 15
(UL: University of Limerick),
Aidan Hegarty1
Estimated H-index: 1
(University Hospital Limerick)
+ 3 AuthorsStewart R. Walsh Mb BCh MRCSEd43
Estimated H-index: 43
(UL: University of Limerick)
Sources
Abstract
Background Full-body CT scanning is increasingly being used in the initial evaluation of severely injured patients. We sought to analyse the literature to determine the benefits of full-body scanning in terms of mortality and length of time spent in the emergency department (ED). Methods A systematic search of the Pubmed and Cochrane Library databases was performed. Eligible studies compared trauma patients managed with selective CT scanning with patients who underwent immediate full-body scanning. Using random effects modelling, the pooled OR was used to calculate the effect of routine full-body CT on mortality while the pooled weighted mean difference was used to analyse the difference in ED time. Results Five studies (8180 patients) provided mortality data while four studies (6073 patients) provided data on ED time. All were non-randomised cohort studies and were prone to several sources of bias. There was no mortality difference between groups (pooled OR=0.68; 95% CI 0.43 to 1.09, p=0.11). There was a significant reduction in the time spent in the ED when patients underwent full-body CT (pooled effect size of weighted mean difference=−32.39 min; 95% CI −51.78 to −13.00; p=0.001). Conclusions We eagerly await the results of randomised controlled trials. Firm clinical outcome data are expected to emerge in the near future, though data on cost and radiation exposure will be needed before definitive conclusions can be made.
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Background: Computed tomography (CT) scanning has become essential in the early diagnostic phase of trauma care because of its high diagnostic accuracy. The introduction of multi-slice CT scanners and infrastructural improvements made total-body CT scanning technically feasible and its usage is currently becoming common practice in several trauma centers. However, literature provides limited evidence whether immediate total-body CT leads to better clinical outcome then conventional radiographic ...
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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.
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#1Anna Bågenholm (UNN: University Hospital of North Norway)H-Index: 2
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espanolObjetivo Analizar la asociacion de la realizacion de una tomografia computarizada (TC) corporal con la mortalidad intrahospitalaria en pacientes de edad avanzada con afectacion toracoabdominopelvica que precisa ingreso en una unidad de cuidados intensivos. Pacientes y metodo Estudio observacional, descriptivo y retrospectivo realizado sobre 140 pacientes con edad igual o mayor de 65 anos ingresados en una unidad de cuidados intensivos tras un traumatismo con afectacion toracoabdominopelvi...
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#1S. Huber-Wagner (TUM: Technische Universität München)
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