Predictors for the Selection of Patients for Abdominal CT After Blunt Trauma

Abstract

Based on parameters from physical examination, laboratory, FAST, and CR, we created a prediction model with a high sensitivity to select patients for abdominal CT after blunt trauma. A diagnostic algorithm was proposed.

Severity and treatment of “occult” intra-abdominal injuries in blunt trauma victims

“…It is therefore important to emphasize the need for specific criteria in order to limit and restrict indications for CT to the minimum necessary number. There are currently various models proposed for the identification, or exclusion, of intra-abdominal injuries that are based on clinical, laboratory and imaging (radiography and ultrasound) variables [1,13,[22][23][24][25][26][27].…”

An evidence based blunt trauma protocol

“…FAST, CR and CT are interpreted by the resident in radiology, with at least 1 year of experience in radiology or by an emergency radiologist, immediately. The flow chart contains imaging criteria that were derived from the literature, existing guidelines and our own experience 6 9 11 15. Patients who are ABC (according to ATLS: airway, breathing or circulation) unstable (respiratory rate <10 or >29/minute, oxygen saturation <95%, pulse rate >100/minute or systolic blood pressure <100 mm Hg) first undergo immediate CR and FAST.…”

“…We recently developed and implemented a new detailed evidence-based diagnostic protocol for radiological imaging during primary evaluation of adult blunt high-energy trauma patients in our Emergency Department (ED). For this diagnostic protocol, data from previous studies concerning thorax and abdomen have been pooled and combined with national guidelines for cervical vertebrae and brain 6 10 12 15. It includes criteria for whether chest and pelvic CR, FAST and CT of the head, cervical spine, chest and abdomen should be performed or can be safely omitted.…”

Incidental findings on routine thoracoabdominal computed tomography in blunt trauma patients

“…16 The results of the additional value of MDCT are described in previously published articles. [17][18][19][20] In this study, approved by the institutional review board, radiologic and clinical data were collected from patients presented for primary care at the emergency department of our Level I trauma center. All blunt trauma patients aged 16 years and older were included in a high-energy trauma protocol.…”