scholarly journals Incidental Findings on Whole-body Computed Tomography in Major Trauma Patients: Who and What?

2021 ◽  
pp. 000313482199868
Author(s):  
Ping-Yuan Liu ◽  
Ling-Wei Kuo ◽  
Chien-Hung Liao ◽  
Chi-Hsun Hsieh ◽  
Francesco Bajani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Incidental Findings ◽  
Major Trauma ◽  
Neck Region ◽  
Whole Body ◽  
Trauma Patients ◽  
Computed Tomography Images ◽  
Whole Body Computed Tomography ◽  
Head Neck

Purpose Whole-body computed tomography (WBCT) scans are frequently used for trauma patients, and sometimes, nontraumatic findings are observed. We aimed to investigate the characteristics of patients with nontraumatic findings on WBCT. Methods From 2013 to 2016, adult trauma patients who underwent WBCT were enrolled. The proportions of nontraumatic findings in different anatomical regions were studied. Nontraumatic findings were classified and evaluated as clinically important findings and findings that needed no further follow-up or treatment. The characteristics of the patients with nontraumatic findings were analyzed and compared with those of patients without nontraumatic findings. Results Two hundred seventeen patients were enrolled in this study during the 3-year study period, and 89 (41.0%) patients had nontraumatic findings. Nontraumatic findings were found more frequently in the abdomen (69.2%) than in the head/neck (17.3%) and chest regions (13.5%). In total, 31.3% of the findings needed further follow-up or treatment. Patients with nontraumatic findings that needed further management were significantly older than those without nontraumatic findings (57.3 vs. 38.9; P < .001), particularly those with abdominal nontraumatic findings (57.9 vs. 41.3; P < .001). A significantly higher proportion of women were observed in the group with head/neck nontraumatic findings that needed further management than in the group without nontraumatic findings (56.3% vs 24.9%; P = .015). Conclusions Whole-body computed tomography could provide alternative benefits for nontraumatic findings. Whole-body computed tomography images should be read carefully for nontraumatic findings, particularly for elderly patients or the head/neck region of female patients. A comprehensive program for the follow-up of nontraumatic findings is needed.

scholarly journals Incidental Findings on Whole-body Computed Tomography in Major Trauma Patients: Who and What?

2020 ◽  
Author(s):  
Ping-Yuan Liu ◽  
Ling-Wei Kuo ◽  
Chien-Hung Liao ◽  
Chi-Hsun Hsieh ◽  
Francesco Bajani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Incidental Findings ◽  
Major Trauma ◽  
Neck Region ◽  
Whole Body ◽  
Trauma Patients ◽  
Whole Body Computed Tomography ◽  
Head Neck ◽  
Thyroid Lesions

Abstract Background The use of whole-body computed tomography (WBCT) scans has greatly increased in the management of patients with major trauma. Sometimes, nontraumatic findings on WBCT are observed. In the current study, we aimed to investigate the proportion of nontraumatic findings on WBCT in major trauma patients and the characteristics of patients with nontraumatic findings on WBCT.Methods From June 2013 to May 2016, adult trauma patients who received WBCT were enrolled. The proportions of nontraumatic findings in different anatomical regions were studied. Nontraumatic findings were classified and evaluated as clinically important findings and findings that did not need further follow-up or treatment. The characteristics of patients with nontraumatic findings were analyzed and compared with those of patients without nontraumatic findings.Results A total of 217 patients were enrolled in this study during the 3-year study period, and 89 (41.0%) patients had nontraumatic findings. Nontraumatic findings were found more frequently in the abdomen (69.2%) than in the head/neck (17.3%) and chest regions (13.5%). In total, 31.3% of the findings needed further follow-up or treatment. Patients with nontraumatic findings that needed further management were significantly older than patients without nontraumatic findings (57.3 vs. 38.9, p<0.001), especially those with abdominal nontraumatic findings (57.9 vs. 41.3, p<0.001). A significantly higher proportion of females was observed in the group with head/neck nontraumatic findings that needed further management than in the group without nontraumatic findings (56.3% vs. 24.9%, p=0.015).Conclusions WBCT could provide alternative benefits for nontraumatic findings. The WBCT images should be read carefully for nontraumatic findings, especially for elderly patients. For female patients, the head/neck region should be carefully evaluated with WBCT for possible thyroid lesions. A comprehensive program for the follow-up of nontraumatic findings is needed.

scholarly journals P014: Incidental findings in trauma whole-body CT scans: a systematic review

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S69-S69
Author(s):  
V. Tsang ◽  
K. Bao ◽  
J. Taylor
Keyword(s):  
Systematic Review ◽  
Incidental Findings ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Subsequent Treatment ◽  
Whole Body ◽  
Trauma Patients ◽  
Patient Demographics ◽  
Study Results

Introduction: Whole-body computed tomography scans (WBCT) are a mainstay in the work-up of polytrauma or multiple trauma patients in the emergency department. While incredibly useful for identifying traumatic injuries, WBCTs also reveal incidental findings in patients, some of which require further diagnostic testing and subsequent treatment. Although the presence of incidental findings in WBCTs have been well documented, there has been no systematic review conducted to organize and interpret findings, determine IF prevalence, and document strategies for best management. Methods: A systematic review was conducted using MEDLINE, PUBMED, and EMBASE. Specific journals and reference lists were hand-mined, and Google Scholar was used to find any additional papers. Data synthesis was performed to gather information on patient demographics, prevalence and type of incidental findings (IFs), and follow-up management was collected. All documents were independently assessed by the two reviewers for inclusion and any disagreements were resolved by consensus. Results: 1231 study results were identified, 59 abstracts, and 12 included in final review. A mean of 53.9% of patients had at least one IF identified, 31.5% had major findings, and 68.5% had minor findings. A mean of 2.7 IFs per patient was reported for articles that included number of total IFs. The mean age of patients included in the studies were 44 years old with IFs more common in older patients and men with more IFs than women. IFs were most commonly found in the abdominal/pelvic region followed by kidneys. Frequency of follow-up documentation was poor. The most common reported mechanisms of injury for patients included in the study were MVA and road traffic accidents (60.0%) followed by falls from >3m (23.2%). Conclusion: Although there is good documentation on the mechanism of injury, patient demographics, and type of IF, follow-up for IFs following acute trauma admission lacks documentation and follow-up and is an identified issue in patient management. There is great need for systematic protocols to address management of IFs in polytrauma patients.

scholarly journals Whole-body computed tomography is safe, effective and efficient in the severely injured hemodynamically unstable trauma patient

2020 ◽  
Author(s):  
Carlos Alberto Ordoñez ◽  
Michael Parra ◽  
Alfonso Holguín ◽  
Carlos Garcia ◽  
Monica Guzmán-Rodríguez ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Damage Control ◽  
Hemodynamic Instability ◽  
Whole Body ◽  
Trauma Patients ◽  
Severely Injured ◽  
Hemostatic Resuscitation ◽  
Whole Body Computed Tomography ◽  
Technological Advances

Trauma is a complex pathology that requires an experienced multidisciplinary team with an inherent quick decision-making capacity, given that a few minutes could represent a matter of life or death. These management decisions not only need to be quick but also accurate to be able to prioritize and to efficiently control the injuries that may be causing impending hemodynamic collapse. In essence, this is the cornerstone of the concept of Damage Control Trauma Care. With current technological advances, physicians have at their disposition multiple diagnostic imaging tools that can aid in this prompt decision-making algorithm. This manuscript aims to perform a literature review on this subject and to share the experience on the use of Whole Body Computed Tomography as a potentially safe, effective, and efficient diagnostic tool in cases of severely injured trauma patients regardless of their hemodynamic status. Our general recommendation is that, when feasible, perform a Whole-Body Computed Tomography without interrupting ongoing hemostatic resuscitation in cases of severely injured trauma patients with or without signs of hemodynamic instability. The use of this technology will aid in the decision-making of the best surgical approach for these patients without incurring any delay in definitive management and/or increasing significantly their radiation exposure.

scholarly journals Evaluation of the role of whole body computed tomography in the management of minor trauma patients.

2021 ◽  
Author(s):  
Gökhan AKSEL ◽  
İbrahim ALTUNOK ◽  
Şeref Kerem ÇORBACIOĞLU ◽  
Hatice Şeyma AKÇA ◽  
Öner BOZAN ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Whole Body ◽  
Trauma Patients ◽  
Minor Trauma ◽  
Whole Body Computed Tomography
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