Seref Kerem Çorbacıoğlu1, Erhan Er2, Sahin Aslan2, Meltem Seviner2, Gökhan Aksel3, Nurettin Özgür Doğan4, Sertaç Güler5, Aysen Bitir6. 1. Emergency Medicine Specialist, Kecioren Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey. Electronic address: keremserefcorbacioglu@gmail.com. 2. Emergency Medicine Specialist, Antakya State Hospital, Department of Emergency Medicine, Hatay, Turkey. 3. Emergency Medicine Specialist, Umraniye Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey. 4. Emergency Medicine Specialist, Kocaeli University, Faculty of Medicine, Department of Emergency Medicine, Kocaeli, Turkey. 5. Emergency Medicine Specialist, Ankara Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey. 6. Thoracic Surgeon, Antakya State Hospital, Department of Chest Surgery, Hatay, Turkey.
Abstract
PURPOSE: The purpose of this study is to investigate whether the use of thoracic computed tomography (TCT) as part of nonselective computed tomography (CT) guidelines is superior to selective CT during the diagnosis of blunt chest trauma. SUBJECTS AND METHODS: This study was planned as a prospective cohort study, and it was conducted at the emergency department between 2013 and 2014. A total of 260 adult patients who did not meet the exclusion criteria were enrolled in the study. All patients were evaluated by an emergency physician, and their primary surveys were completed based on the Advanced Trauma Life Support (ATLS) principles. Based on the initial findings and ATLS recommendations, patients in whom thoracic CT was indicated were determined (selective CT group). Routine CTs were then performed on all patients. RESULTS: Thoracic injuries were found in 97 (37.3%) patients following routine TCT. In 53 (20%) patients, thoracic injuries were found by selective CT. Routine TCT was able to detect chest injury in 44 (16%) patients for whom selective TCT would not otherwise be ordered based on the EP evaluation (nonselective TCT group). Five (2%) patients in this nonselective TCT group required tube thoracostomy, while there was no additional treatment provided for thoracic injuries in the remaining 39 (15%). CONCLUSION: In conclusion, we found that the nonselective TCT method was superior to the selective TCT method in detecting thoracic injuries in patients with blunt trauma. Furthermore, we were able to demonstrate that the nonselective TCT method can change the course of patient management albeit at low rates.
PURPOSE: The purpose of this study is to investigate whether the use of thoracic computed tomography (TCT) as part of nonselective computed tomography (CT) guidelines is superior to selective CT during the diagnosis of blunt chest trauma. SUBJECTS AND METHODS: This study was planned as a prospective cohort study, and it was conducted at the emergency department between 2013 and 2014. A total of 260 adult patients who did not meet the exclusion criteria were enrolled in the study. All patients were evaluated by an emergency physician, and their primary surveys were completed based on the Advanced Trauma Life Support (ATLS) principles. Based on the initial findings and ATLS recommendations, patients in whom thoracic CT was indicated were determined (selective CT group). Routine CTs were then performed on all patients. RESULTS: Thoracic injuries were found in 97 (37.3%) patients following routine TCT. In 53 (20%) patients, thoracic injuries were found by selective CT. Routine TCT was able to detect chest injury in 44 (16%) patients for whom selective TCT would not otherwise be ordered based on the EP evaluation (nonselective TCT group). Five (2%) patients in this nonselective TCT group required tube thoracostomy, while there was no additional treatment provided for thoracic injuries in the remaining 39 (15%). CONCLUSION: In conclusion, we found that the nonselective TCT method was superior to the selective TCT method in detecting thoracic injuries in patients with blunt trauma. Furthermore, we were able to demonstrate that the nonselective TCT method can change the course of patient management albeit at low rates.
Authors: Ashraf F Hefny; Fathima T Kunhivalappil; Nikolay Matev; Norman A Avila; Masoud O Bashir; Fikri M Abu-Zidan Journal: Singapore Med J Date: 2017-07-25 Impact factor: 1.858
Authors: Klemens Horst; Hagen Andruszkow; Christian D Weber; Miguel Pishnamaz; Christian Herren; Qiao Zhi; Matthias Knobe; Rolf Lefering; Frank Hildebrand; Hans-Christoph Pape Journal: PLoS One Date: 2017-10-19 Impact factor: 3.240