title: An abdominal computed tomography may be safe in selected hypotensive trauma patients with positive Focused Assessment with Sonography in Trauma examination.
abstract: BACKGROUND
  Positive Focused Assessment with Sonography in Trauma examination and hypotension often indicate urgent surgery. An abdomen/pelvis computed tomography (apCT) may allow less invasive management but the delay may be associated with adverse outcomes.
  
  
  METHODS
  Patients in the Prospective Observational Multicenter Major Trauma Transfusion study with hypotension and a positive Focused Assessment with Sonography in Trauma (HF+) examination who underwent a CT (apCT+) were compared with those who did not.
  
  
  RESULTS
  Of the 92 HF+ identified, 32 (35%) underwent apCT during initial evaluation and apCT was associated with decreased odds of an emergency operation (odds ratio .11, 95% confidence interval .001 to .116) and increased odds of angiographic intervention (odds ratio 14.3, 95% confidence interval 1.5 to 135). There was no significant difference in 30-day mortality or need for dialysis.
  
  
  CONCLUSIONS
  An apCT in HF+ patients is associated with reduced odds of emergency surgery, but not mortality. Select HF+ patients can safely undergo apCT to obtain clinically useful information.
authors: Department of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code L611, Portland, OR 97239, USA. Electronic address: cookmac@ohsu.edu.
authors: Mackenzie R
authors: MR
authors: Cook
authors: Department of Surgery, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors: John B
authors: JB
authors: Holcomb
authors: Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors: Mohammad H
authors: MH
authors: Rahbar
authors: Department of Surgery, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors: Erin E
authors: EE
authors: Fox
authors: Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
authors: Louis H
authors: LH
authors: Alarcon
authors: Department of Surgery, University of Washington, Seattle, WA, USA.
authors: Eileen M
authors: EM
authors: Bulger
authors: Department of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code L611, Portland, OR 97239, USA.
authors: Karen J
authors: KJ
authors: Brasel
authors: Department of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code L611, Portland, OR 97239, USA.
authors: Martin A
authors: MA
authors: Schreiber
mesh_terms: D000007:Abdominal Injuries / Q000150:complications / Q000000981:diagnostic imaging*; D000328:Adult; D001794:Blood Pressure; D005260:Female; D006801:Humans; D007022:Hypotension / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D011446:Prospective Studies; D011860:Radiography, Abdominal; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*; D015599:Trauma Severity Indices; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Computed tomography scan; FAST examination; Trauma