Literature DB >> 24158205

Incidental findings in patients with multiple injuries: how to proceed?

Miriam Ruesseler1, Anna Schill, Thomas Lehnert, Hendrik Wyen, Sebastian Wutzler, Ingo Marzi, Felix Walcher.   

Abstract

BACKGROUND: Multislice computed tomography (MSCT) is the diagnostic criterion standard for the initial evaluation of patients with suspected multiple injuries. Besides scanning for injuries directly related to the initial trauma, MSCT scans can reveal pathologies unrelated to the trauma of clinical relevance.The aim of the present study was to determine the frequency and follow-up course of incidental findings in patients with multiple injuries.
METHODS: This is a retrospective analysis of prospectively collected data on 2,242 patients with suspected multiple injuries at a Level I trauma center from 2006 to 2010.The MSCT reports were retrospectively reviewed regarding abnormal findings not related to trauma. These incidental findings were classified on a four-point level scoring system with respect to clinical importance and urgency for further diagnostic and therapeutic procedures.
RESULTS: During initial trauma center evaluation in the emergency department, 2,246 patients met our inclusion criteria. A total of 2,036 patients (90.7%) underwent MSCT; 1,142 (50.9%) of the patients had one or more incidental findings. A total of 2,844 incidental findings were detected. Overall, 349 tumor findings were noted (12.3% of all incidental findings); 113 findings were suspicious for malignant processes or metastasis. According to our classification, 168 (5.9%) of the incidental findings required urgent follow-up (Level 4), and 527 (18.5%) of the incidental findings required a follow-up before discharge (Level 3).
CONCLUSION: MSCT in patients with multiple injuries reveals one or more incidental findings in more than one of two patients. A scoring system classifying for relevance of incidental findings was introduced and could be applied in routine trauma care in the future. LEVEL OF EVIDENCE: Epidemiologic study, level III.

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Year:  2013        PMID: 24158205     DOI: 10.1097/TA.0b013e3182a925b9

Source DB:  PubMed          Journal:  J Trauma Acute Care Surg        ISSN: 2163-0755            Impact factor:   3.313


  7 in total

1.  Incidental findings in blunt trauma patients: prevalence, follow-up documentation, and risk factors.

Authors:  Melissa K James; Michael P Francois; Gideon Yoeli; Geoffrey K Doughlin; Shi-Wen Lee
Journal:  Emerg Radiol       Date:  2017-02-09

2.  The prevalence of incidental findings on computed tomography of the abdomen/pelvis in pediatric trauma patients.

Authors:  C Onwubiko; D P Mooney
Journal:  Eur J Trauma Emerg Surg       Date:  2017-06-08       Impact factor: 3.693

3.  Frequency, Recognition, and Potential Risk Factors of Incidental Findings on Trauma Computed Tomography Scans: A Cross-Sectional Study at an Urban Level One Trauma Center.

Authors:  Wei-An Lai; Pang-Hsu Liu; Ming-Jen Tsai; Ying Chieh Huang
Journal:  J Acute Med       Date:  2020-09-01

4.  Incidental CT Findings in the Elderly with Low-Energy Falls: Prevalence and Implications.

Authors:  Sandra Niedermeier; Rebecca Wania; Alina Lampart; Robert Stahl; Christoph Trumm; Christian Kammerlander; Wolfgang Böcker; Christian H Nickel; Roland Bingisser; Marco Armbruster; Vera Pedersen
Journal:  Diagnostics (Basel)       Date:  2022-01-30

5.  Improving Incidental Finding Documentation in Trauma Patients Amidst Poor Access to Follow-up Care.

Authors:  Marguerite W Spruce; Jessica A Bowman; Alice J Wilson; Joseph M Galante
Journal:  J Surg Res       Date:  2019-12-26       Impact factor: 2.192

6.  CT scan incidental findings in trauma patients: does it impact hospital length of stay?

Authors:  Peter Andrawes; Antonio I Picon; Masood A Shariff; Basem Azab; Wolf von Waagner; Seleshi Demissie; Charles Fasanya
Journal:  Trauma Surg Acute Care Open       Date:  2017-09-14

7.  Incidental Findings in CT and MR Angiography for Preoperative Planning in DIEP Flap Breast Reconstruction.

Authors:  Ryan D Wagner; Andres F Doval; Nikhilesh V Mehra; Hung B Le; Paul A Niziol; Warren A Ellsworth; Aldona J Spiegel
Journal:  Plast Reconstr Surg Glob Open       Date:  2020-10-23
  7 in total

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