Whole-body multislice computed tomography as the first line diagnostic tool in patients with multiple injuries: the focus on time.
OBJECTIVE
Whole-body multislice helical computed tomography (MSCT) becomes increasingly important as a diagnostic tool in patients with multiple injuries. We describe time requirement of two different diagnostic approaches to multiple injuries one with whole-body-MSCT (MSCT Trauma-Protocol) as the sole radiologic procedure and one with conventional use of radiography, combined with abdominal ultrasound and organ focused CT (Conventional-Trauma-Protocol).


METHODS
Observational study with retrospective analysis of time requirements for resuscitation, diagnostic workup and transfer to definitive treatment after changing from conventional to MSCT Trauma-Protocol. Group I: data from trauma patients imaged with whole-body MSCT. Group II: data of trauma patients investigated with conventional trauma protocol before the introduction of MSCT-Trauma-Protocol.


RESULTS
The complete diagnostic workup in group I (n = 82) was finished after 23 minutes (17-33 minutes) [median; interquartile range (IQR)] and after 70 minutes (IQR, 56-85) in group II (n = 79). The definitive management plan based on a completed diagnostic workup was devised after 47 minutes (IQR, 37-59) in group I and after 82 minutes (IQR, 66-110) in group II.


CONCLUSIONS
A whole-body MSCT-based diagnostic approach to multiple injuries might shorten the time interval from arrival in the trauma emergency room until obtaining a final diagnosis and management plan in patients with multiple injuries and might, therefore, contribute to improvements in patient care.
Wurmb
Thomas Erik
TE
Department of Anesthesiology, University Hospital Wuerzburg, Wuerzburg, Germany. wurmb_t@klinik.uni-wuerzburg.de
Frühwald
Peter
P
Hopfner
Witiko
W
Keil
Thorsten
T
Kredel
Markus
M
Brederlau
Jörg
J
Roewer
Norbert
N
Kuhnigk
Herbert
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002648:Child; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital; D004867:Equipment Design; D005260:Female; D005858:Germany; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000601:surgery; D012151:Resuscitation / Q000295:instrumentation; D012189:Retrospective Studies; D013673:Technology Assessment, Biomedical; D013996:Time and Motion Studies; D036542:Tomography, Spiral Computed / Q000295:instrumentation*; D014218:Triage; D051598:Whole Body Imaging / Q000295:instrumentation*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000601:surgery; D055815:Young Adult