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Effects on mortality, treatment, and time management as a result of routine use of total body computed tomography in blunt high-energy trauma patients

Authors :
Jaap Deunk
Michael J. Edwards
Raoul van Vugt
Digna R. Kool
Source :
Journal of Trauma and Acute Care Surgery, 72, 553-9, Journal of Trauma and Acute Care Surgery, 72, 3, pp. 553-9
Publication Year :
2012

Abstract

Item does not contain fulltext BACKGROUND: Currently, total body computed tomography (TBCT) is rapidly implemented in the evaluation of trauma patients. With this review, we aim to evaluate the clinical implications-mortality, change in treatment, and time management-of the routine use of TBCT in adult blunt high-energy trauma patients compared with a conservative approach with the use of conventional radiography, ultrasound, and selective computed tomography. METHODS: A literature search for original studies on TBCT in blunt high-energy trauma patients was performed. Two independent observers included studies concerning mortality, change of treatment, and/or time management as outcome measures. For each article, relevant data were extracted and analyzed. In addition, the quality according to the Oxford levels of evidence was assessed. RESULTS: From 183 articles initially identified, the observers included nine original studies in consensus. One of three studies described a significant difference in mortality; four described a change of treatment in 2% to 27% of patients because of the use of TBCT. Five studies found a gain in time with the use of immediate routine TBCT. Eight studies scored a level of evidence of 2b and one of 3b. CONCLUSION: Current literature has predominantly suboptimal design to prove terminally that the routine use of TBCT results in improved survival of blunt high-energy trauma patients. TBCT can give a change of treatment and improves time intervals in the emergency department as compared with its selective use. 01 maart 2012

Details

ISSN :
21630755
Database :
OpenAIRE
Journal :
Journal of Trauma and Acute Care Surgery, 72, 553-9, Journal of Trauma and Acute Care Surgery, 72, 3, pp. 553-9
Accession number :
edsair.doi.dedup.....3621d179da3f54b4df6eeb1f2c8480de
Full Text :
https://doi.org/10.1097/TA.0b013e31822dd93b