title: Benefit of the Vittel criteria to determine the need for whole body scanning in a severe trauma patient.
abstract: OBJECTIVE
  To evaluate the use of the Vittel criteria in addition to a clinical examination to determine the need for a whole body scan (WBS) in a severe trauma patient.
  
  
  METHODS
  Between December 2008 and November 2009, 339 severe trauma patients with at least one Vittel criterion were prospectively evaluated with a WBS. The following data were collected: the Vittel criteria present, circumstances of the accident, traumatic injury on the WBS, and irradiation. The original intent to prescribe a computed tomography (CT) scan (whole body or a targeted region), based solely on clinical signs, was specified.
  
  
  RESULTS
  Injuries were diagnosed in 55.75% of the WBS (n=189). The most common Vittel criteria were "global assessment" (n=266), "thrown, run over" (n=116), and "ejected from vehicle" (n=94). The multivariate analysis used the following as independent criteria for predicting severe traumatic injury on the WBS: Glasgow score less than 13, penetrating trauma, and colloid resuscitation greater than 11. Based solely on clinical factors, 164 patients would not have had any scan or (only) a targeted scan. In that case, 15% of the severe injuries would have been missed.
  
  
  CONCLUSIONS
  Using the Vittel criteria to determine the need for a WBS in a severe trauma patient makes it possible to find serious injuries not suspected on the clinical examination, but at the cost of an increased number of normal scans.
authors.affiliation: Department of Radiology, CHU Angers, 4, rue Larrey, 49990 Angers cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Babaud
authors.forename: C
authors.initials: C
authors.lastname: Ridereau-Zins
authors.forename: G
authors.initials: G
authors.lastname: Bouhours
authors.forename: J
authors.initials: J
authors.lastname: Lebigot
authors.forename: R
authors.initials: R
authors.lastname: Le Gall
authors.forename: S
authors.initials: S
authors.lastname: Bertrais
authors.forename: P M
authors.initials: PM
authors.lastname: Roy
authors.forename: C
authors.initials: C
authors.lastname: Aubé
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis*; D011446:Prospective Studies; D051598:Whole Body Imaging; D055815:Young Adult