title: [Costs and role of ultrasound follow-up of polytrauma patients after initial computed tomography].
abstract: OBJECTIVE
  To assess the costs and diagnostic gain of abdominal ultrasound follow-up of polytrauma patients initially examined by whole-body computed tomography (CT).
  
  
  METHODS
  A total of 176 patients with suspected multiple trauma (126 men, 50 women; age 43.5 ± 17.4 years) were retrospectively analyzed with regard to supplementary and new findings obtained by ultrasound follow-up compared with the results of exploratory FAST (focused assessment with sonography for trauma) at admission and the findings of whole-body CT. A process model was used to document the staff, materials, and total costs of the ultrasound follow-up examinations.
  
  
  RESULTS
  FAST yielded 26 abdominal findings (organ injury and/or free intra-abdominal fluid) in 19 patients, while the abdominal scan of whole-body CT revealed 32 findings in 25 patients. FAST had 81 % sensitivity and 100 % specificity. Follow-up ultrasound examinations revealed new findings in 2 of the 25 patients with abdominal injuries detected with initial CT. In the 151 patients without abdominal injuries in the initial CT scan, ultrasound follow-up did not yield any supplementary or new findings. The total costs of an ultrasound follow-up examination were EUR 28.93. The total costs of all follow-up ultrasound examinations performed in the study population were EUR 5658.23.
  
  
  CONCLUSIONS
  Follow-up abdominal ultrasound yields only a low overall diagnostic gain in polytrauma patients in whom initial CT fails to detect any abdominal injuries but incurs high personnel expenses for radiological departments.
authors.affiliation: Klinik für diagnostische und interventionelle Radiologie, Charité - Universitätsmedizin Berlin, Berlin. martin.maurer@charite.de
authors.forename: M H
authors.initials: MH
authors.lastname: Maurer
authors.forename: A
authors.initials: A
authors.lastname: Winkler
authors.forename: F
authors.initials: F
authors.lastname: Wichlas
authors.forename: M-J
authors.initials: MJ
authors.lastname: Powerski
authors.forename: F
authors.initials: F
authors.lastname: Elgeti
authors.forename: A
authors.initials: A
authors.lastname: Huppertz
authors.forename: R
authors.initials: R
authors.lastname: Röttgen
authors.forename: T
authors.initials: T
authors.lastname: Marnitz
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis / Q000191:economics; D000328:Adult; D003937:Diagnosis, Differential; D003953:Diagnosis-Related Groups / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006465:Hemoperitoneum / Q000175:diagnosis / Q000191:economics; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000191:economics*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis* / Q000191:economics; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000191:economics*; D014463:Ultrasonography / Q000191:economics*; D019564:Unnecessary Procedures / Q000191:economics; D051598:Whole Body Imaging / Q000191:economics