TITLE

Trauma management incorporating focused assessment with computed tomography in trauma (FACTT) - potential effect on survival

AUTHOR(S)
Kanz, Karl-Georg; Paul, April O.; Lefering, Rolf; Kay, Mike V.; Kreimeier, Uwe; Linsenmaier, Ulrich; Mutschler, Wolf; Huber-Wagner, Stefan
PUB. DATE
January 2010
SOURCE
Journal of Trauma Management & Outcomes;2010, Vol. 4, p4
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Immediate recognition of life-threatening conditions and injuries is the key to trauma management. To date, the impact of focused assessment with computed tomography in trauma (FACTT) has not been formally assessed. We aimed to find out whether the concept of using FACTT during primary trauma survey has a negative or positive effect on survival. Methods: In a retrospective, multicentre study, we compared our time management and probability of survival (Ps) in major trauma patients who received FACTT during trauma resuscitation with the trauma registry of the German Trauma Society (DGU). FACTT is defined as whole-body computed tomography (WBCT) during primary trauma survey. We determined the probability of survival according to the Trauma and Injury Severity Score (TRISS), the Revised Injury Severity Classification score (RISC) and the standardized mortality ratio (SMR). Results: We analysed 4.817 patients from the DGU database from 2002 until 2004, 160 (3.3%) were from our trauma centre at the Ludwig-Maximilians-University (LMU) and 4.657 (96.7%) from the DGU group. 73.2% were male with a mean age of 42.5 years, a mean ISS of 29.8. 96.2% had suffered from blunt trauma. Time from admission to FAST (focused assessment with sonography for trauma)(4.3 vs. 8.7 min), chest x-ray (8.1 vs. 16.0 min) and whole-body CT (20.7 vs. 36.6 min) was shorter at the LMU compared to the other trauma centres (p < 0.001). SMR calculated by TRISS was 0.74 (CI95% 0.40-1.08) for the LMU (p = 0.24) and 0.92 (CI95% 0.84-1.01) for the DGU group (p = 0.10). RISC methodology revealed a SMR of 0.69 (95%CI 0.47-0.92) for the LMU (p = 0.043) and 1.00 (95%CI 0.94-1.06) for the DGU group (p = 0.88). Conclusion: Trauma management incorporating FACTT enhances a rapid response to life-threatening problems and enables a comprehensive assessment of the severity of each relevant injury. Due to its speed and accuracy, FACTT during primary trauma survey supports rapid decision-making and may increase survival.
ACCESSION #
51925291

 

Related Articles

  • Isolated Small Bowel Perforation After Blunt Abdominal Trauma: Report Of 2 Cases. Symeonidis, Nikolaos; Ballas, Konstantinos; Psarras, Kyriakos; Lalountas, Miltiadis; Rafailidis, Savvas; Pavlidis, Theodoros; Sakantamis, Athanasios // Internet Journal of Surgery;Apr2011, Vol. 27 Issue 1, p1 

    Isolated perforation of the small bowel after blunt abdominal trauma is infrequent and the diagnosis can be elusive. Although computerized tomography is the modality most commonly used, there is no consensus over the optimal diagnostic approach. Diagnostic difficulties result in delayed surgical...

  • Monitoring midline shift by transcranial color-coded sonography in traumatic brain injury: A comparison with cranial computerized tomography. Pou, Juan Antonio Llompart; Centellas, Josep María Abadal; Sans, Margarita Palmer; Bárcena, Jon Pérez; Vivas, Marcial Casares; Ramírez, Javier Homar; Ibáñez#Juvé, Jorge // Intensive Care Medicine;Aug2004, Vol. 30 Issue 8, p1672 

    Objective. Transcranial color-coded duplex sonography (TCCDS) is a non invasive bedside technique that allows the determination of midline shift (MLS). The purpose of our study was to compare MLS measurements using TCCDS with those obtained with cranial computerized tomography (CT) in patients...

  • Blunt trauma of the heart: CT pattern of atrial appendage ruptures. Wintermark, M.; Delabays, A.; Bettex, D.; Schnyder, P. // European Radiology;Jan2001, Vol. 11 Issue 1, p113 

    Blunt trauma patients with myocardial ruptures rarely survive long enough to reach a trauma center; however, for the survivors, prompt diagnosis and surgery are mandatory and save up to 80 % of patients. Preoperative diagnosis of myocardial ruptures is assessed by echocardiography or, more...

  • Blunt Trauma Evaluation and Management: Pitfalls to Avoid. Grossheim, Lisa Freeman; Bowman, Mary Jo // Pediatric Emergency Medicine Reports;Nov2007, Vol. 12 Issue 11, p1 

    This article discusses the caveats in the evaluation and management of blunt trauma patients in both the community hospital and trauma center. The author examines the most cost-effective manner in the evaluation and management of blunt trauma. She suggests that clinicians should recognize the...

  • Traumatic injuries: radiological hemostatic intervention at admission. Dondelinger, R.; Trotteur, G.; Ghaye, B.; Szapiro, D. // European Radiology;May2002, Vol. 12 Issue 5, p979 

    Blunt trauma victims and selected patients with penetrating trauma are systematically investigated after resuscitation and hemodynamic stabilization with cross-sectional imaging. Computed tomography is a good predictor of the need for hemostatic arteriographic embolization, based on contrast...

  • The efficacy of four-slice helical CT in evaluating pancreatic trauma: a single institution experience. Wei-Jing Lee; Ning-Ping Foo; Hung-Jung Lin; Yen-Chang Huang; Kuo-Tai Chen // Journal of Trauma Management & Outcomes;2011, Vol. 5 Issue 1, p1 

    Study objective: To assess the efficacy of computed tomography (CT) in evaluating patients with pancreatic trauma. Methods: We undertook a retrospective review of all blunt trauma patients admitted to the Chi-Mei Medical Center from January 2004 to June 2006. Every patients underwent abdominal...

  • Management of Liver Trauma. Badger, S.; Barclay, R.; Campbell, P.; Mole, D.; Diamond, T. // World Journal of Surgery;Dec2009, Vol. 33 Issue 12, p2522 

    Background: Blunt and penetrating liver trauma is common and often presents major diagnostic and management problems. Methods: A literature review was undertaken to determine the current consensus on investigation and management strategies. Results: The liver is the most frequently injured organ...

  • Successful Limb Reperfusion Using Prolonged Intravascular Shunting in a Case of an Unstable Trauma Patient. Nalbandian, M. M.; Maldonado, T. S.; Cushman, J.; Jacobowitz, G. J.; Lamparello, P. J.; Riles, T. S. // Vascular & Endovascular Surgery;Jul/Aug2004, Vol. 38 Issue 4, p375 

    When peripheral vascular injuries present in conjunction with life threatening emergencies, controlling hemorrhage from a peripheral blood vessel may take initial priority, however, sacrificing a limb to preserve life is a well-established dictum. The use of intravascular shunts has allowed...

  • Evaluation of gastrointestinal injury in blunt abdominal trauma "FAST is not reliable": the role of repeated ultrasonography. Mohammadi, Afshin; Ghasemi-rad, Mohammad // World Journal of Emergency Surgery;2012, Vol. 7 Issue 1, p1 

    Background: To determine the diagnostic Accuracy of Focused Assessment Sonography for Trauma (FAST) and repeated FAST in the patients with blunt abdominal trauma. Methods: In this retrospective study we collected the data of all patients from September 2007 to July 2011 with gastrointestinal...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics