Background: There is an important increase in the use of whole body computed tomography (WBCT) around the world although its benefits are still controversial.We hypothesized that the use of a WBCT protocol in the major trauma patients based on mechanism of injury alone would reduce the number of injuries that would have been missed if CT was only done based on clinical findings. Study design:A prospective observational study with the inclusion of 144 patients with major blunt trauma during 5 months at our academic center. Data were collected from all patients including: epidemiology, clinical status on scene and at the emergency department, time of the scan (including patient handling), clinical findings during initial assessment and WBCT scan findings, dividing exams in with or without findings (normal). Looking for findings that would go unnoticed if CT was done based on clinical findings. Glasgow coma scale (GCS) 15 and GCS <15 were compared and data are presented as absolute values of mean ± SD. Analysis of data was done with Chi-square test (p < 0.05). Results:One hundred forty-four patients with major trauma that were included in the protocol. Normal CT scan was found in 44 cases and 100 scans had at least one positive finding associated with the trauma and 35 CTs (25%) had at least one injury that would be missed without the WBCT protocol. Glasgow coma scale of 15 patients and those with 14 or less were compared regarding the number of normal vs positive scan (p = 0.45) and for scans with unnoticed injuries (p = 0.1) and there was no difference between the two groups.Conclusion: A significant number of injuries would have been missed if a WBCT scan protocol based on mechanism of injury was not used in our center. There was no difference in the number of probably missed injuries in patients with a GCS = 15 or those with GCS ≤ 14.
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