Whole-body multislice computed tomography (MSCT) improves trauma care in patients requiring surgery after multiple trauma.
OBJECTIVE
Whole-body multislice helical CT becomes increasingly important as a diagnostic tool in patients with multiple injuries. Time gain in multiple-trauma patients who require emergency surgery might improve outcome. The authors hypothesised that whole-body multislice computed tomography (MSCT) (MSCT trauma protocol) as the initial diagnostic tool reduces the interval to start emergency surgery (tOR) if compared to conventional radiography, combined with abdominal ultrasound and organ-focused CT (conventional trauma protocol). The second goal of the study was to investigate whether the diagnostic approach chosen has an impact on outcome.


METHODS
The authors' level 1 trauma centre uses whole-body MSCT for initial radiological diagnostic work-up for patients with suspected multiple trauma. Before the introduction of MSCT in 2004, a conventional approach was used. Group I: data of trauma patients treated with conventional trauma protocol from 2001 to 2003. Group II: data from trauma patients treated with whole-body MSCT trauma protocol from 2004 to 2006.


RESULTS
tOR in group I (n=155) was 120 (90-150) min (median and IQR) and 105 (85-133) min (median and IQR) in group II (n=163), respectively (p<0.05). Patients of group II had significantly more serious injuries. No difference in outcome data was found. 14 patients died in both groups within the first 30 days; five of these died within the first 24 h.


CONCLUSIONS
A whole-body MSCT-based diagnostic approach to multiple trauma shortens the time interval to start emergency surgery in patients with multiple injuries. Mortality remained unchanged in both groups. Patients of group II were more seriously injured; an improvement of outcome might be assumed.
Wurmb
T E
TE
Department of Anaesthesiology, University Hospital of Wuerzburg, Oberdürrbacherstrasse 6, 97080 Würzburg, Germany. wurmb_t@klinik.uni-wuerzburg.de
Quaisser
C
C
Balling
H
H
Kredel
M
M
Muellenbach
R
R
Kenn
W
W
Roewer
N
N
Brederlau
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D036542:Tomography, Spiral Computed / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography; D051598:Whole Body Imaging