Silvia Fernández Noel (Madrid / ES), Marta Gutierrez Andreu (Madrid / ES), Nicolás Pareja Arico (Madrid / ES), Julia Bernal Tirapo (Madrid / ES), Alejandro Moreno Bargueiras (Madrid / ES), Carmen Sanchez (Madrid / ES), Daniel Pastor-Altaba (Madrid / ES), Alberto García-Picazo (Madrid / ES), Pedro Yuste (Madrid / ES), Eduardo Ferrero-Herrero (Madrid / ES)
Abstract text (incl. references and figure legends)
Introduction
Most present guidelines contraindicate performing CT scan in ustable polytrauma patient and determine direct transfer to the operating room (OR). Recently, CT scan has been considered as first evaluation, regardless of hemodynamic stability.
Material and methods
We identified all severe polytrauma patients evaluated at our institution between 01/01/2019 and 31/12/2020. We defined hemodynamically unstable patients as those who required vasoactive drugs (VSA) in the primary evaluation. We analyzed the following variables: age, sex, focused assessment with Sonography for Trauma (FAST), CT scan before or after surgery, need of surgical intervention, complications, intensive care unit (ICU), length of stay and acute-phase mortality.
Results
Of the 108 patients evaluated in the study period, 31 required VSA and were included for the analysis. 35,5% were women and 64,5% men. 80,6% of the VSA group underwent FAST, with positive results in 45,2%. A CT scan was performed in 93,5%: 72,4% before surgery and only 27,6% after surgery.
Global mortality was 20,7%: 14,3% were in cases with CT scan before surgery, and 37,5% in cases with CT after surgery, not being statistically significant (Image 1 and 2).
No statistically significant differences were obtained between CT scan before or after surgery regarding ICU length of stay, complications, OR time and mortality.
Conclusions
A new paradigm is opened on the use of CT body in hemodynamically unstable patients. In our study the mortality was higher in patients where the CT scan was done after surgery. However no statistically significant differences were found, may be related to a small sample, so we will carry out further studies to be able to study this new paradigm.
References
Huber-Wagner, Stefana; Kanz, Karl-Georga et al. Whole-body computed tomography in severely injured patients. Current Opinion in Critical Care: February 2018 - Volume 24 - Issue 1 p 55-61.Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)
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