title: Non-traumatic incidental findings in patients undergoing whole-body computed tomography at initial emergency admission.
abstract: OBJECTIVE
  To evaluate the number, localisation and importance of non-traumatic incidental findings (IFs) in patients with suspected or obvious multiple trauma undergoing whole-body CT (WBCT) in a level-1 trauma centre.
  
  
  METHODS
  Between January 2009 and December 2013, a total of 2440 patients with trauma undergoing WBCT at admission to a level-1 trauma centre of a university hospital were retrospectively analysed, through imaging IFs unrelated to trauma with the radiological reports. All IFs were grouped into four categories according to their clinical relevance. Category 1: urgent treatment or further clarification needed; category 2: further examination and follow-up within 3-6 months required; category 3: findings with no immediate consequences for the treatment of the patient but of potential relevance in the future; category 4: harmless findings.
  
  
  RESULTS
  Altogether, 5440 IFs in 2440 patients (1735 male, 705 female; mean age 45.1 years) were documented. In 204 patients (8.4%) urgent category 1 findings were reported, 766 patients (31.4%) had category 2 findings, 1236 patients (50.7%) had category 3 findings and 1173 patients (48.1%) had category 4 findings. Most IFs were detected in the abdomen/pelvis (42.5%). 602 (24.7%) of the patients had no IFs.
  
  
  CONCLUSIONS
  WBCT scans of unrelated trauma patients demonstrate a high rate of IF. A substantial percentage (8.4%) of patients had urgent category 1IFs and a high percentage (31.4%) had category 2 IFs requiring a follow-up. This high number of patients with polytrauma undergoing WBCT, having IFs of high relevance, poses a major challenge for the level-1 trauma centre in the acute and postacute management of these patients.
authors.affiliation: Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany.|Department for Diagnostic and Interventional Neuroradiology, University Medical Centre Göttingen, Göttingen, Germany.
authors.forename: Eduard K
authors.initials: EK
authors.lastname: Kroczek
authors.affiliation: Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany.
authors.forename: Gero
authors.initials: G
authors.lastname: Wieners
authors.affiliation: Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Steffen
authors.affiliation: Department of Emergency Medicine, Charité - University Medicine Berlin, Berlin, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Lindner
authors.affiliation: Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Streitparth
authors.affiliation: Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.affiliation: Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany.|Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: Martin H
authors.initials: MH
authors.lastname: Maurer
mesh_terms: D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051598:Whole Body Imaging
keywords: CT/MRI; emergency department management; epidemiology; imaging; major incidents; major trauma management; non-traumatic problems