Incidental findings on whole-body trauma computed tomography: Experience at a major trauma centre

Seah, Matthew; Murphy, Colin G.; McDonald, Scott D.; Carrothers, Andrew

doi:10.1016/j.injury.2016.01.012

Cited by 40 publications

(39 citation statements)

References 15 publications

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“…reported that sharing information pertaining to incidental findings with a patient's primary care doctor helps ensure reliable follow‐up observation. Furthermore, Seah et al . suggested countermeasures for incidental findings, including listing in medical records, clarifying follow‐up, clarifying consultation services, sharing information, and listing findings, in discharge summaries.…”

Section: Discussionmentioning

confidence: 99%

Incidental findings on whole‐body computed tomography in trauma patients: the current state of incidental findings and the effect of implementation of a feedback system

Kumada

Murakami

Okada

et al. 2019

Acute Medicine & Surgery

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Aim Whole‐body computed tomography (CT) for trauma occasionally reveals significant incidental findings not related to trauma, which require an adequate response. In this study, we examined the current state of incidental findings in trauma patients on whole‐body CT and the effects of the feedback system. Methods The subject sample included trauma patients who underwent whole‐body CT while being examined for trauma during the 2‐year period, with the interpretation of the CT reported by a radiologist. The frequency and recognition of incidental findings and the involved body region were investigated. The state of incidental findings before and after implementation of a radiography report feedback system was also examined. Results During the study period, whole‐body CT revealed incidental findings in 79 of 199 trauma patients (40.1%). The mean age of the 79 patients with incidental findings was 62.8 ± 19.5 years, and the mean injury severity score was 16.6 ± 10.0. No difference was observed in the severity of trauma, age, or length of hospital stay. The incidental findings were related to the liver/gallbladder in 22 patients, kidneys in 17, lungs in 14, and the intracranial area in 13. The recognition rate of incidental findings after the implementation of the feedback system increased from 23.3% to 32.6%. Conclusions Considering that not all incidental findings are accurately recognized, a proper feedback system is required. A feedback system is beneficial and a need to ensure improvement in the recognition of incidental findings.

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Section: Discussionmentioning

confidence: 99%

Incidental findings on whole‐body computed tomography in trauma patients: the current state of incidental findings and the effect of implementation of a feedback system

Kumada

Murakami

Okada

et al. 2019

Acute Medicine & Surgery

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“…[ 9 ] Previously, the rate of IFs was up to 75% on whole body CT in trauma patients. [ 10 – 17 ] Moreover, some IFs are not reported by the radiologist. An explanation might be that they were not seen by the radiologist or they were valued as not important enough to be reported.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular findings on computed tomography in patients with unclear finding situation and trauma of unknown origin

Meyer

Schramm²,

Bach³

et al. 2017

Medicine

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Incidental cardiovascular findings are common and can be found in up to 70% of patients. Previously, several reports about incidental findings (IFs) on whole body computed tomography (CT) were published. However, no previous study investigated cardiovascular IFs in patients with unclear finding situation and trauma of unknown origin on whole body CT.The radiological database of 2 university hospitals was screened for patients with trauma of unknown origin and unclear finding situation investigated by whole body CT. The images were retrospectively analyzed by 2 radiologists in consensus. The findings were classified according to their clinical relevance. Clinically nonrelevant findings like valvular sclerosis, aortic sclerosis, or anatomic variants were excluded from this study. Moreover, the radiology reports were analyzed to assess initial reporting by the radiologist.Overall, we identified 60 patients with a mean age of 63 years. A total of 98 clinically relevant cardiovascular IFs (CRCIF) were identified in 60 (75%) patients (1.6 CRCIF per patient). The most prevalent finding was cardiomegaly in 23 patients, followed by coronary sclerosis in 21 patients and aortic ectasia in 11 patients; other findings were rarer. Sixty-one findings were reported (62.2%) and 37 were nonreported (37.8%). Thirty patients (50%) showed no traumatic event on whole body CT.CRCIFs are common in patients with unclear finding situation and trauma of unknown origin. Despite initial indication for trauma detection, the whole body CT should carefully be evaluated for CRCIF because of the high prevalence of clinically relevant findings. Notably, 37.76% of the findings were not reported by the radiologist.

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“…In many studies, it has been shown that the percentage of pathology detected in WBCT is more than 50%, but only some of them require intervention. [26] Kroczek et al, [27] in their study of 2440 multi-trauma patients, stated that in 8.4% of patients who underwent whole-body CT, the lesion requiring urgent intervention was detected, while in 31% of those who underwent WBCT additional lesions were detected. In our study, additional trauma was detected in 78 patients (39.4%).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the necessity of whole body scan tomography in cases with head trauma

Yasaran

Karakuş

Kuvandık

et al. 2019

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: In our study, we have tried to find out how necessary whole-body computed tomography (WBCT) is to detect other body injuries that may accompany the patients, evaluating head trauma cases with WBCT. METHODS: In our study, we included 198 patients, who were referred to our hospital's emergency service after head trauma, had brain lesions detected in brain tomography (BT), had no additional examination findings and who underwent WBCT. In this retrospective study, patients' age, gender, type of lesion in brain CT, Glasgow Coma Scale (GCS) values and WBCT findings were examined. RESULTS: In this study, 85.4% of the patients were male and the average age was 25.7 years. The most common cranial CT findings were fracture, followed by parenchymal bleeding. 67% of the patients' GCS were below 8. Additional trauma was detected in 78 of the patients (39.4%). The most common additional lesion was the thoracic contusion. The mean age of the patients with cervical injuries determined in CT was significantly high (p<0.05). Statistical significance was determined between cranial fracture, foreign body incidence and thoracic injuries (p<0.05). The incidence of cervical injuries was significantly higher in patients with brain contusion detected in CT (p<0.05). Fracture frequency and presence of additional lesions in WBCT were significantly high (p<0.05). There was no correlation between other cranial lesions and additional injury areas (p>0.05). CONCLUSION: The number of studies evaluating WBCT is high in the literature. However, our study is important concerning that to our knowledge this study is the first study to evaluate the WBCT findings in the head trauma cases without the additional lesions on their bodies. WBCT scan should be recommended in patients whose clinical evaluation could not be completed. WBCT is an important diagnostic tool for the diagnosis of many pathologies, especially for intrathoracic lesions.

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Incidental findings on whole-body trauma computed tomography: Experience at a major trauma centre

Cited by 40 publications

References 15 publications

Incidental findings on whole‐body computed tomography in trauma patients: the current state of incidental findings and the effect of implementation of a feedback system

Incidental findings on whole‐body computed tomography in trauma patients: the current state of incidental findings and the effect of implementation of a feedback system

Cardiovascular findings on computed tomography in patients with unclear finding situation and trauma of unknown origin

Evaluation of the necessity of whole body scan tomography in cases with head trauma

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