BACKGROUND: Whole-body CT scan is the cornerstone of trauma-related injury assessment. Several lines of evidence indicate that significant number of injuries may remain undetected after the initial hot report of CT. Missed injuries (MI) represent an important issue in trauma patients, for they may increase morbidity, mortality and costs. The aim of this study was to examine incidence and predictors of MI in trauma patients undergoing whole-body CT scan. METHODS: 177 CT scan performed upon admission of trauma patients during year 2005 were reviewed by a radiologist blinded to patient's initial data. MI was defined as injuries not written in the initial report. Patients with and without MI were compared to determine predictors of MI by multivariable analysis. RESULTS: 157 MI were diagnosed in 85 (47%) patients. MI was predominantly encoded AIS 2 (57%) or 3 (29%). Patients with MI had significantly higher SAPSII, higher ISS and were more frequently sedated. Age over 50 years (OR: 4.37, p=0.003) and ISS over 14 (OR: 4.17, p<0.0001) were independent predictors of MI. Median ISS after encoding MI was significantly higher than initial ISS (22 vs. 20 p<0.0001). After adjustment for severity, mortality and length of stay were not different between patients with or without MI. CONCLUSION: Trauma patients, especially aged and severe, experienced a high rate of missed injuries in the initial hot report which appeared to be predominantly minor and musculoskeletal, advocating a CT scan second reading.
BACKGROUND: Whole-body CT scan is the cornerstone of trauma-related injury assessment. Several lines of evidence indicate that significant number of injuries may remain undetected after the initial hot report of CT. Missed injuries (MI) represent an important issue in traumapatients, for they may increase morbidity, mortality and costs. The aim of this study was to examine incidence and predictors of MI in traumapatients undergoing whole-body CT scan. METHODS: 177 CT scan performed upon admission of traumapatients during year 2005 were reviewed by a radiologist blinded to patient's initial data. MI was defined as injuries not written in the initial report. Patients with and without MI were compared to determine predictors of MI by multivariable analysis. RESULTS: 157 MI were diagnosed in 85 (47%) patients. MI was predominantly encoded AIS 2 (57%) or 3 (29%). Patients with MI had significantly higher SAPSII, higher ISS and were more frequently sedated. Age over 50 years (OR: 4.37, p=0.003) and ISS over 14 (OR: 4.17, p<0.0001) were independent predictors of MI. Median ISS after encoding MI was significantly higher than initial ISS (22 vs. 20 p<0.0001). After adjustment for severity, mortality and length of stay were not different between patients with or without MI. CONCLUSION:Traumapatients, especially aged and severe, experienced a high rate of missed injuries in the initial hot report which appeared to be predominantly minor and musculoskeletal, advocating a CT scan second reading.
Authors: J P Kepros; R C Opreanu; R Samaraweera; A Briningstool; C A Morrison; B D Mosher; P Schneider; P Stevens Journal: Eur J Trauma Emerg Surg Date: 2012-07-12 Impact factor: 3.693
Authors: F Münn; R A Laun; A Asmus; R Bülow; S Bakir; L Haralambiev; A Eisenschenk; S Kim Journal: BMC Musculoskelet Disord Date: 2020-01-22 Impact factor: 2.362
Authors: Stefan Wirth; Julian Hebebrand; Raffaella Basilico; Ferco H Berger; Ana Blanco; Cem Calli; Maureen Dumba; Ulrich Linsenmaier; Fabian Mück; Konraad H Nieboer; Mariano Scaglione; Marc-André Weber; Elizabeth Dick Journal: Insights Imaging Date: 2020-12-10
Authors: Dirk Stengel; Sven Mutze; Claas Güthoff; Moritz Weigeldt; Konrad von Kottwitz; Domenique Runge; Filip Razny; Anna Lücke; Dirk Müller; Axel Ekkernkamp; Thomas Kahl Journal: JAMA Surg Date: 2020-03-01 Impact factor: 14.766