The Value of Abdominal and Pelvic CT Scan in Trauma Patients With Low Injury Severity Score and High Glasgow Coma Scale

Wasfie, Tarik; Rivera, Daniel; Naisan, Mursal; Zaremba, Shelby; Depuydt, Mikayla; Read, Sydney; Hella, Jennifer; Barber, Kimberly; Yapchai, Raquel; Shapiro, Brian

doi:10.1177/00031348211047496

Cited by 1 publication

(1 citation statement)

References 14 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…16 However, the outcome is unchanged as the majority (86%) either failed to follow up, or did not need additional tests, and therefore a CT contribution to immediate management is doubtful. 16,17 Increasing age carries with it a high incidence of finding an incidentaloma in the chest and so as the use of anticoagulant therapy and those patients should be taken into consideration when ordering a CCT. The length of stay in our group 2 was high which reflects the effort and the time the physician needs to evaluate and consult different specialties to address the incidental findings.…”

Section: Discussionmentioning

confidence: 99%

Value of Thoracic CT in Blunt Trauma Patients With High Glasgow Coma Scale and Low Injury Severity Scale

Wasfie

Hardy

Naisan³

et al. 2023

The American Surgeon™

Self Cite

View full text Add to dashboard Cite

Objective To determine the value of ordering a routine chest CT (CCT) in patients with blunt trauma presenting to the emergency department with a high GCS and low ISS, we retrospectively collected patient data including CT scan results, when physical examination and initial chest X-ray were normal in the trauma bay area. Methods A retrospective data collection of 901 consecutive blunt trauma patients seen in the ED between 2017 and 2019 was analyzed. Data included physical examination, age, gender, current use of anticoagulation therapy, comorbid conditions, as well as the result of radiologic images, hospital length of stay, surgical intervention, and mortality. The patients were divided into two groups: group one (patients with negative physical examination; chest x-ray and CT) and group 2 (negative physical examination, positive or negative chest x-ray, and positive CT). Statistical analysis was performed using student’s t-test and chi-square test. Results Of the 901 patients there were 489 (54%) males and 412 (46%) females with a mean age of 56 years. There were 461 patients who had a physical examination, chest x-ray, abdominal and CCT done. Group one included 442 (96%) patients, with negative physical examination, negative chest X-ray and CT scan. In group 2, 19 (4%) patients who had positive CT and or chest x-ray. Both groups were similar in GCS and ISS. Of the 19 patients, sixteen patients had a positive CCT, and thirteen of those had a positive chest x-ray. In the three patients who had negative physical examination and chest x-ray, the CT findings included one with a nondisplaced 10th rib fracture and two patients with osteoporotic compression fractures of dorsal vertebrae. The rate of both chest x-ray and CCT being positive among a group of screened patients was 16% (3/19) and the rate of a negative chest x-ray but positive CT was 16% (3/19). The odds ratio between the two outcomes was one. Conclusion In blunt trauma patients presenting to the ED with a high GCS and low ISS score, when initial physical examination and chest x-ray are negative, routine CCT is of little value.

show abstract

Section: Discussionmentioning

confidence: 99%