ArticleOpen access emergency medicine : OAEM2020
Negative Whole-Body Computed Tomography Scans in Polytrauma Patients: A Retrospective Cohort Study.
Article in Open access emergency medicine : OAEM, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 6 citations in OpenAlex.
- Whole-Body Computed Tomography (WBCT) for the initial assessment of trauma patients: a retrospective observational study.Emergency radiology · 2026Observational
- Article
- Rationalizing whole-body computed tomography in trauma: A national audit on resource utilization and strategies to minimize radiation exposure.World journal of radiology · 2026Article
- Investigating the Potential Overuse of Pan-Computed Tomography (PanCT) Examinations in Trauma Cases in Emergency Departments.Medicina (Kaunas, Lithuania) · 2024Article
- Severely injured patients: modern management strategies.EFORT open reviews · 2023Review
- Major trauma with only dynamic criteria: is the routine use of whole-body CT as a first level examination justified?La Radiologia medica · 2022Article
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Authors and funding
7 authors at 5 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundWhole-body computed tomography (WBCT) has been a mainstay and an integral part of the evaluation of polytrauma patients in trauma centers and emergency departments (ED) for a comprehensive evaluation of the extent of injuries. However, routine use of WBCT remains controversial since it exposes patients to radiation and exponentially increases financial expense. The primary objective was to determine the rate of negative WBCT in polytrauma patients. PATIENTS AND
methodsA retrospective cohort study was conducted at an academic hospital in the Kingdom of Saudi Arabia, which is a dedicated trauma center with a mean of 237,392 ED visits and 10,714 trauma per year. The study included all adult (≥18 years) polytrauma patients who presented to our ED, requiring trauma team activation, and underwent WBCT as part of their evaluation from January 2016 to May 2017. We excluded pediatric patients, patients transferred from another facility, and pregnant patients. The primary endpoint was to measure the rate of negative WBCT in polytraumatized patients.
resultsA total of 186 patients were included with a mean age of 28.8 ± 12.9 years. The rate of negative WBCT scans was 20.4%. The positive scans were subclassified based on the number of anatomical body regions that were affected radiologically. One body region was affected in 47 patients (31.8%), two body regions were affected in 50 patients (33.8%), and ≥3 body regions were affected in 51 patients (34.3%). In a subset analysis, we identified that oxygen saturation <94% and GCS ≤8 were associated with positive CT scans.
conclusionOur study revealed a slightly higher rate of utilization of WBCT in the management of trauma patients compared to studies with similar practice. We believe that in the correct setting with incorporating high index of suspicion, a physical examination with attention to vital signs and mental status, performing E-FAST, and dedicated X-Rays is a way to potentially reduce the use of WBCT in polytrauma patients.
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