BACKGROUND: In light of current trends to limit radiation exposure and costs, as well as increased traffic safety, computed tomography (CT) may have decreasing value for evaluating patients with blunt trauma. The authors examined the utility of chest x-ray and abdominal CT for identifying clinically significant thoracic blunt trauma. METHODS: In this prospective study, findings on thoracic CT, abdominal CT, and chest x-ray from trauma patients were compared to assess injury prevalence and relevance to treatment outcomes. RESULTS: Four hundred forty-four patients were identified, of whom 76% had no findings. Occult findings had significantly lower Injury Severity Scores. All clinically relevant pneumothoraces and most other injuries could be identified without thoracic CT. Two of 3 aortic abnormalities were suspected from chest x-ray. CONCLUSIONS: Clinically significant injuries can be identified with abdominal CT and chest x-ray, safely allowing reductions in radiation exposure, hospital stays, and costs by limiting the use of thoracic CT.
BACKGROUND: In light of current trends to limit radiation exposure and costs, as well as increased traffic safety, computed tomography (CT) may have decreasing value for evaluating patients with blunt trauma. The authors examined the utility of chest x-ray and abdominal CT for identifying clinically significant thoracic blunt trauma. METHODS: In this prospective study, findings on thoracic CT, abdominal CT, and chest x-ray from traumapatients were compared to assess injury prevalence and relevance to treatment outcomes. RESULTS: Four hundred forty-four patients were identified, of whom 76% had no findings. Occult findings had significantly lower Injury Severity Scores. All clinically relevant pneumothoraces and most other injuries could be identified without thoracic CT. Two of 3 aortic abnormalities were suspected from chest x-ray. CONCLUSIONS: Clinically significant injuries can be identified with abdominal CT and chest x-ray, safely allowing reductions in radiation exposure, hospital stays, and costs by limiting the use of thoracic CT.
Authors: Sjirk J Westra; Paul G Thacker; Daniel J Podberesky; Edward Y Lee; Ramesh S Iyer; Shilpa V Hegde; R Paul Guillerman; Maryam Ghadimi Mahani Journal: Pediatr Radiol Date: 2015-02-06