Ruth Easton1, Krisztian Sisak, Zsolt J Balogh. 1. Department of Traumatology, Division of Surgery, John Hunter Hospital and University of Newcastle, Newcastle, New South Wales, Australia.
Abstract
BACKGROUND: Computed tomography (CT) can facilitate the diagnosis of life-threatening injuries in polytrauma patients. Reported times to imaging vary widely, but it has been suggested that rapid whole body scanning improves mortality rates. The aim of this study was to determine the time to CT for severe polytrauma patients presenting to a level I trauma centre in Australia. METHODS: Retrospective audit of prospectively collected trauma registry data combined with electronic medical records. Inclusion criteria were trauma patients with injury severity score ≥16 who underwent CT scanning over a 12-month period. Exclusion criteria were scans performed at regional centres or greater than 5 h after arrival. Time to commencement of CT was defined as time from arrival to the first CT image being recorded, and time to completion of CT as the time from arrival to recording the final CT image. Time in CT was defined as minutes between acquisition of the first and final images. RESULTS: Two hundred thirty-three eligible patients were admitted over the study period. CT acquisition times were median 76 min (interquartile range (IQR) 52-115) to commencement, 93 min (IQR 71-129) to completion and time in CT 14 min (IQR 6-24). Time to completion was faster for isolated head scans, abbreviated injury scale head >3, intubated patients and those with subsequent fatal outcome. CONCLUSIONS: Although 93 min to completion of trauma CT scans is comparable with some international reports, it falls well behind centres who have demonstrated improved outcomes with CT scanning. Our results serve as a baseline to our and potentially other Australasian trauma centres to improve on this surrogate measure of trauma team efficacy.
BACKGROUND: Computed tomography (CT) can facilitate the diagnosis of life-threatening injuries in polytraumapatients. Reported times to imaging vary widely, but it has been suggested that rapid whole body scanning improves mortality rates. The aim of this study was to determine the time to CT for severe polytraumapatients presenting to a level I trauma centre in Australia. METHODS: Retrospective audit of prospectively collected trauma registry data combined with electronic medical records. Inclusion criteria were traumapatients with injury severity score ≥16 who underwent CT scanning over a 12-month period. Exclusion criteria were scans performed at regional centres or greater than 5 h after arrival. Time to commencement of CT was defined as time from arrival to the first CT image being recorded, and time to completion of CT as the time from arrival to recording the final CT image. Time in CT was defined as minutes between acquisition of the first and final images. RESULTS: Two hundred thirty-three eligible patients were admitted over the study period. CT acquisition times were median 76 min (interquartile range (IQR) 52-115) to commencement, 93 min (IQR 71-129) to completion and time in CT 14 min (IQR 6-24). Time to completion was faster for isolated head scans, abbreviated injury scale head >3, intubated patients and those with subsequent fatal outcome. CONCLUSIONS: Although 93 min to completion of trauma CT scans is comparable with some international reports, it falls well behind centres who have demonstrated improved outcomes with CT scanning. Our results serve as a baseline to our and potentially other Australasian trauma centres to improve on this surrogate measure of trauma team efficacy.