title: Appropriateness of CT of the chest, abdomen, and pelvis in motorized blunt force trauma patients without signs of significant injury.
abstract: OBJECTIVE
  The purpose of this article is to determine the frequency of clinically significant injuries detected on CT of the chest, abdomen, and pelvis in adult patients involved in motorized blunt force trauma with normal clinical examinations.
  
  
  METHODS
  A retrospective review of the medical records of patients presenting with a triage history of motorized blunt force trauma who underwent CT of the chest, abdomen, and pelvis at the time of presentation was performed. Hemodynamically stable adult patients without abnormal physical examination findings to suggest injury of the trunk (e.g., tenderness, deformity, or bruising over the chest, abdomen, or pelvis) were included in the study. The formal report of the CT scan was reviewed and all acute injuries were recorded. Admission and discharge dates and surgical interventions were also recorded.
  
  
  RESULTS
  Records for 542 patients were reviewed; 108 patients (74 men and 34 women; median age, 36 years) fulfilled the inclusion criteria. Eleven of the 108 patients (10%; 95% CI, 4.4-15.6%) had acute injuries detected on CT of the chest, abdomen, and pelvis. None of the injuries required direct medical intervention. Alcohol intoxication or distracting injuries were present in eight of these patients. The median time in hospital, from emergency department presentation to discharge, was 4.4 days (interquartile range, 2.5-8.5 days) for patients who were admitted and 6.7 hours (interquartile range, 4.8-10.3 hours) for those who were discharged.
  
  
  CONCLUSIONS
  The clinical yield of performing CT of the chest, abdomen, and pelvis in motorized blunt trauma patients with normal clinical examinations in our study was minimal.
authors: Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada. millo@ualberta.ca
authors: Noam Ze'ev
authors: NZ
authors: Millo
authors: Chris
authors: C
authors: Plewes
authors: Brian H
authors: BH
authors: Rowe
authors: Gavin
authors: G
authors: Low
mesh_terms: D000007:Abdominal Injuries / Q000473:pathology*; D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000293:injuries*; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D007472:Iohexol