Increasing use of whole body computed tomography scans in "non-shockroom" patients after trauma: Indications, findings and therapeutic consequences

Abstract text (incl. references and figure legends)

Background: The whole-body computed tomography (WBCT) scan is an essential adjunct in the management of polytraumatized patients and has been shown to result in an improvement in survival prognosis. The goal of the present study was to analyze the role of the WBCT scan in "non-shockroom" trauma patients.

Methods: Retrospective analysis of all patients admitted to our emergency department from 01/2019 – 12/2021 and who received a WBCT scan in a "non-shockroom" situation. Indications for WBCT scan, specific injuries and therapeutic consequences were examined.

Results: During the 3-year study period, a total of 504 WBCT scans was performed. The number of WBCT scans significantly increased over the years (2019: n=78 (2.5% of all ED patients), 2020: n=91 (3.2%), 2021: n=335 (11.3%); p<0.001). The most frequent WBCT scan indications included high energy trauma (n=228, 45.2%) and suspicion of multiple injuries on clinical examination (n=190, 37.7%). Overall, 56.7% of the scans (n=286) were positive. The encountered injuries consisted of chest trauma (n=155, 30.8%), head injury (n=111, 22.0%), spine fractures (n=95, 18.8%), intraabdominal organ lacerations (n=63, 12.5%), pelvic fractures (n=27, 5.4%), vascular injuries (n=24, 4.8%), and extremity fractures (n=12, 2.4%). Based on the findings of the WBCT scan, surgery and/or interventional radiology procedures were required in 77 (15.3%) patients and mostly included spine surgery (n=16) and thoracic surgery (n=8).

Conclusion: The use of a WBCT scan has significantly increased and has become an integral part in our evaluation algorithm of trauma patients also in the "non-shockroom" situation. However, clear indication protocols are required to avoid unnecessary radiation exposure.

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.)

No