title: CT Chest with IV Contrast Compared with CT Angiography after Blunt Trauma.
abstract: Blunt aortic injury (BAI) after chest trauma is a potentially lethal condition. Rapid diagnosis is important to appropriately treat patients. The purpose of this study was to compare CT with intravenous contrast (CTI) to CT with angiography (CTA) in the initial evaluation of blunt chest trauma patients. This was a retrospective review of all blunt trauma patients who received a CTI or CTA during the initial evaluation at an urban Level I trauma center from January 1, 2010 to December 31, 2013. Two-hundred and eighty-one trauma patients met inclusion criteria. Most, 167/281 (59%) received CTI and 114/281 (41%) received CTA. There were no differences between cohorts in age, gender, initial heart rate, systolic blood pressure, and Glasgow Coma Scale in emergency department. Mortality rates were similar for CTI and CTA (4% vs 8%, P = 0.20). CTI identified an injury in 54 per cent compared with 46 per cent in CTA (P = 0.05). Overall, 2 per cent of patients had BAI with similar rates in CTI and CTA (2% vs 2%, P = 0.80). BAI was not missed using either CTI or CTA. Trauma patients studied with CTI had similar diagnostic findings as CTA. CTI may be preferable to CTA during the initial assessment for possible BAI because of a single contrast injection for whole body CT.
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Zaw
authors.forename: Donovan
authors.initials: D
authors.lastname: Stewart
authors.forename: Jason S
authors.initials: JS
authors.lastname: Murry
authors.forename: David M
authors.initials: DM
authors.lastname: Hoang
authors.forename: Beatrice
authors.initials: B
authors.lastname: Sun
authors.forename: Sogol
authors.initials: S
authors.lastname: Ashrafian
authors.forename: Heidi
authors.initials: H
authors.lastname: Hotz
authors.forename: Rex
authors.initials: R
authors.lastname: Chung
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Margulies
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Ley
mesh_terms: D000328:Adult; D000792:Angiography / Q000379:methods*; D002140:California; D015331:Cohort Studies; D003287:Contrast Media; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007262:Infusions, Intravenous; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013898:Thoracic Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014193:Trauma Centers; D014505:Urban Population; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D003287:Contrast Media