title: Whole-body multislice computed tomography as the primary and sole diagnostic tool in patients with blunt trauma: searching for its appropriate indication.
abstract: In our hospital, whole-body multislice computed tomography is used as the primary diagnostic tool in patients with suspected multiple trauma. A triage rule is used for its indication. We have retrospectively analyzed data of sedated, intubated and ventilated patients consecutively admitted to our trauma center to assess whether the triage rule can help identify patients with severe trauma (injury severity score > or = 16). We have found that overtriage (injury severity score < 16) occurs in 30%, and undertriage occurs in 6% of patients. Although we have found the triage rule to be highly sensitive, this results in a high rate of overtriage. Until we know more about the most relevant and independent predictive factors, sole reliance upon multislice computed tomography in triaging suspected polytrauma victims will imply the risk to overscan many patients.
authors.affiliation: Klinik und Poliklinik für Anästhesiologie der Universität Würzburg, 97080 Würzburg, Germany. wurmb_t@klinik.uni-wuerzburg.de <wurmb_t@klinik.uni-wuerzburg.de>
authors.forename: Thomas Erik
authors.initials: TE
authors.lastname: Wurmb
authors.forename: Peter
authors.initials: P
authors.lastname: Frühwald
authors.forename: Wittiko
authors.initials: W
authors.lastname: Hopfner
authors.forename: Norbert
authors.initials: N
authors.lastname: Roewer
authors.forename: Jörg
authors.initials: J
authors.lastname: Brederlau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014218:Triage; D051598:Whole Body Imaging; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*