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Whole-body CT-based imaging algorithm for multiple trauma patients: radiation dose and time to diagnosis


Gordic, Sonja; Alkadhi, Hatem; Hodel, Sandro; Simmen, Hans-Peter; Brueesch, Martin; Frauenfelder, Thomas; Wanner, Guido; Sprengel, Kai (2015). Whole-body CT-based imaging algorithm for multiple trauma patients: radiation dose and time to diagnosis. British Journal of Radiology:20140616.

Abstract

Objectives: To determine the number of imaging examinations, radiation dose, and the time to complete trauma-related imaging in multiple trauma patients before and after introduction of whole-body CT (WBCT) into early trauma care. Methods: 120 consecutive patients before and 120 patients after introduction of WBCT into our hospitals' trauma algorithm were compared regarding number and type of CT, radiography, focused assessment with sonography for trauma (FAST), additional CT examinations (defined as CT of same body regions after radiography and/or FAST), and the time to complete trauma-related imaging. Results: In the WBCT cohort significantly more patients underwent CT of the head, neck, chest, and abdomen (P<.001) as compared to the non-WBCT cohort, whereas the number of radiography of the cervical spine, chest and pelvis and of FAST examinations were significantly lower (P<.001). There were no significant differences between cohorts regarding the number of radiography of upper (P=.56) and lower extremities (P=.30). We found significantly higher effective doses in the WBCT (29.5mSv) as compared to the non-WBCT cohort (15.9mSv, P<.001), but less additional CT for completing the work-up were needed in the WBCT cohort (P<.001). The time to complete trauma-related imaging was significantly shorter in the WBCT (12min) as compared to the non-WBCT cohort (75min, P<.001). Conclusion: Including WBCT in the initial work-up of trauma patients results in higher radiation dose, but less additional CT is needed, and the time for completing trauma-related imaging is shorter. Advances in knowledge: WBCT in trauma patients is associated with a high radiation dose of 29.5mSv.

Abstract

Objectives: To determine the number of imaging examinations, radiation dose, and the time to complete trauma-related imaging in multiple trauma patients before and after introduction of whole-body CT (WBCT) into early trauma care. Methods: 120 consecutive patients before and 120 patients after introduction of WBCT into our hospitals' trauma algorithm were compared regarding number and type of CT, radiography, focused assessment with sonography for trauma (FAST), additional CT examinations (defined as CT of same body regions after radiography and/or FAST), and the time to complete trauma-related imaging. Results: In the WBCT cohort significantly more patients underwent CT of the head, neck, chest, and abdomen (P<.001) as compared to the non-WBCT cohort, whereas the number of radiography of the cervical spine, chest and pelvis and of FAST examinations were significantly lower (P<.001). There were no significant differences between cohorts regarding the number of radiography of upper (P=.56) and lower extremities (P=.30). We found significantly higher effective doses in the WBCT (29.5mSv) as compared to the non-WBCT cohort (15.9mSv, P<.001), but less additional CT for completing the work-up were needed in the WBCT cohort (P<.001). The time to complete trauma-related imaging was significantly shorter in the WBCT (12min) as compared to the non-WBCT cohort (75min, P<.001). Conclusion: Including WBCT in the initial work-up of trauma patients results in higher radiation dose, but less additional CT is needed, and the time for completing trauma-related imaging is shorter. Advances in knowledge: WBCT in trauma patients is associated with a high radiation dose of 29.5mSv.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Trauma Surgery
04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
Dewey Decimal Classification:610 Medicine & health
Date:16 January 2015
Deposited On:05 Mar 2015 16:59
Last Modified:05 Apr 2016 18:53
Publisher:British Institute of Radiology
ISSN:0007-1285
Publisher DOI:https://doi.org/10.1259/bjr.20140616
PubMed ID:25594105

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