Whole-body CT increases survival for trauma patients

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The use of whole-body CT to image severely injured patients with multiple trauma early significantly increases the probability of survival, according to a retrospective study published online first for an upcoming issue of the Lancet.

Stefan Huber-Wagner, MD, of Munich University Hospital, Ludwig-Maximilians-University in Munich, Germany, and colleagues compared the probability of survival in patients with blunt trauma who had whole-body CT during resuscitation with those who had not.

In the multicenter study, the researchers used the data recorded in the trauma registry of the German Trauma Society to calculate the probability of survival according to the trauma and injury severity score (TRISS), revised injury severity classification (RISC) score and standardized mortality ratio for 4,621 patients with blunt trauma given whole-body or non-whole-body CT.

Of the cohort, 1,494 patients were given whole-body CT, mean age 42.6 years. Of these, 73 percent were men. The mean injury severity score (ISS) was 29.7--showing that the investigated patients did have critical injuries, the authors wrote.

The researchers found that the morality rate based on TRISS was 0.745 for patients given whole-body CT versus 1.023 for those given non-whole-body CT. The mortality rate based on the RISC score was 0.865 for patients given whole-body CT versus 1.034 for those given non-whole-body CT.

"This means that the recorded mortality rate for patients given whole-body CT is significantly lower than predicted with TRISS and RISC-score. The relative risk reduction in mortality for whole-body CT based on TRISS was 25 percent and 13 percent based on RISC. Data adjustment confirmed whole-body CT as an independent predictor of survival," according to Huber-Wagner and colleagues.

The authors concluded that the integration of whole-body CT into early trauma care significantly increased the probability of survival in patients with polytrauma. "On the basis of our findings, we recommend that whole-body CT should be integrated into the early resuscitation phase of severely injured patients as a standard and basic diagnostic method," they wrote.