title: Indications for total-body computed tomography in blunt trauma patients: a systematic review.
abstract: OBJECTIVE
  Total-body CT scanning (TBCT) could improve the initial in-hospital evaluation of severe trauma patients. Indications for TBCT, however, differ between trauma centers, so more insight in how to select patients that could benefit from TBCT is required. The aim of this review was to give an overview of currently used indications for total-body CT in trauma patients and to describe mortality and Injury Severity Scores of patient groups selected for TBCT.
  
  
  METHODS
  A systematic review was performed by searching MEDLINE and Embase databases. Studies evaluating or describing criteria for selection of patients with potentially severe injuries for TBCT during initial trauma care were included. Also, studies comparing total-body CT during the initial assessment of injured patients with conventional imaging and selective CT in specific patient groups were included.
  
  
  RESULTS
  Thirty eligible studies were identified. Three studies evaluated indications for TBCT in trauma with divergent methods. Combinations of compromised vital parameters, severe trauma mechanisms and clinical suspicion on severe injuries are often used indications; however, clinical judgement is used as well. Studies describing TBCT indications selected patients in different ways and were difficult to compare regarding mortality and injury severity.
  
  
  CONCLUSIONS
  Indications for TBCT in trauma show a wide variety in structure and cut-off values for vital parameters and trauma mechanism dimensions. Consensus on indications for TBCT in trauma is lacking.
authors.affiliation: Trauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. k.treskes@amc.nl.
authors.forename: K
authors.initials: K
authors.lastname: Treskes
authors.affiliation: Trauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: T P
authors.initials: TP
authors.lastname: Saltzherr
authors.affiliation: Trauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: J S K
authors.initials: JS
authors.lastname: Luitse
authors.affiliation: Department of Radiology, Academic Medical Center, Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: L F M
authors.initials: LF
authors.lastname: Beenen
authors.affiliation: Trauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: J C
authors.initials: JC
authors.lastname: Goslings
mesh_terms: D006801:Humans; D015601:Injury Severity Score; D018579:Patient Selection; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers; D051598:Whole Body Imaging; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*
keywords: Computed tomography; Multiple trauma; Total-body CT; Whole body imaging; Wounds and injuries