TITLE

Impact of whole-body computed tomography on mortality and surgical management of severe blunt trauma

AUTHOR(S)
Yeguiayan, Jean-Michel; Yap, Anabelle; Freysz, Marc; Garrigue, Delphine; Jacquot, Claude; Martin, Claude; Binquet, Christine; Riou, Bruno; Bonithon-Kopp, Claire
PUB. DATE
May 2012
SOURCE
Critical Care;2012, Vol. 16 Issue 3, p1
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: The mortality benefit of whole-body computed tomography (CT) in early trauma management remains controversial and poorly understood. The objective of this study was to assess the impact of whole-body CT compared with selective CT on mortality and management of patients with severe blunt trauma. Methods: The FIRST (French Intensive care Recorded in Severe Trauma) study is a multicenter cohort study on consecutive patients with severe blunt trauma requiring admission to intensive care units from university hospital trauma centers within the first 72 hours. Initial data were combined to construct a propensity score to receive whole-body CT and selective CT used in multivariable logistic regression models, and to calculate the probability of survival according to the Trauma and Injury Severity Score (TRISS) for 1,950 patients. The main endpoint was 30-day mortality. Results: In total, 1,696 patients out of 1,950 (87%) were given whole-body CT. The crude 30-day mortality rates were 16% among whole-body CT patients and 22% among selective CT patients (p = 0.02). A significant reduction in the mortality risk was observed among whole-body CT patients whatever the adjustment method (OR = 0.58, 95% CI: 0.34-0.99 after adjustment for baseline characteristics and post-CT treatment). Compared to the TRISS predicted survival, survival significantly improved for whole-body CT patients but not for selective CT patients. The pattern of early surgical and medical procedures significantly differed between the two groups. Conclusions: Diagnostic whole-body CT was associated with a significant reduction in 30-day mortality among patients with severe blunt trauma. Its use may be a global indicator of better management.
ACCESSION #
77970155

 

Related Articles

  • Impact on survival of whole-body computed tomography before emergency bleeding control in patients with severe blunt trauma. Daiki Wada; Yasushi Nakamori; Kazuma Yamakawa; Yoshiaki Yoshikawa; Takeyuki Kiguchi; Osamu Tasaki; Hiroshi Ogura; Yasuyuki Kuwagata; Takeshi Shimazu; Toshimitsu Hamasaki; Satoshi Fujimi // Critical Care;2013, Vol. 17 Issue 4, p1 

    Introduction: Whole-body computed tomography (CT) has gained importance in the early diagnostic phase of trauma care. However, the diagnostic value of CT for seriously injured patients is not thoroughly clarified. This study assessed whether preoperative CT beneficially affected survival of...

  • Trauma Patient Unplanned Hospital Re-Admissions. Esposito, Thomas J.; Clark-Kula, Evelyn; Crowe, Melissa; Galambos, Linda; Salameh, Loubna; Gillespie, Janice // Surgical Science;Aug2012, Vol. 3 Issue 8, p381 

    Introduction: Performance monitoring and performance improvement (PI) are increasingly important. Little is known regarding unplanned re-admission (UPR) in trauma patients. This study characterizes UPRs at one institution. Methods: Retrospective descriptive review of UPR to a Level I Trauma...

  • A prospective registry of emergency department patients admitted with infection. Williams, Julian M.; Greenslade, Jaimi H.; McKenzie, Juliet V.; Chu, Kevin H.; Brown, Anthony F. T.; Paterson, David; Lipman, Jeffrey // BMC Infectious Diseases;2011, Vol. 11 Issue 1, p27 

    Background: Patients with infections account for a significant proportion of Emergency Department (ED) workload, with many hospital patients admitted with severe sepsis initially investigated and resuscitated in the ED. The aim of this registry is to systematically collect quality observational...

  • A Comparison of MICU Survival Prediction Using the Logistic Regression Model and Artificial Neural Network Model. Shu-Ping Lin; Chi-Hsueh Lee; Yang-Shu Lu; Ling-Nu Hsu // Journal of Nursing Research (Taiwan Nurses Association);Dec2006, Vol. 14 Issue 4, p306 

    Under the policy of restraint in medical expenditure and with the dual pressures of medical technology development and population aging, the critical care services will exert even greater pressure on the limited medical resources. Therefore, the objective of this study is to compare the...

  • Validation of a Modified Early Warning Score to Predict ICU Transfer for Patients with Severe Sepsis or Septic Shock on General Wards. Ju Ry Lee; Hye Ran Choi // Journal of Korean Academy of Nursing;2014, Vol. 44 Issue 2, p219 

    Purpose: To assess whether the Modified Early Warning Score (MEWS) predicts the need for intensive care unit (ICU) transfer for patients with severe sepsis or septic shock admitted to general wards. Methods: A retrospective chart review of 100 general ward patients with severe sepsis or septic...

  • Factors associated with acute care use among nursing home residents dying of cancer: a population-based study. Bainbridge, Daryl; Hsien Seow; Sussman, Jonathan; Pond, Gregory // International Journal of Palliative Nursing;2015, Vol. 21 Issue 7, p349 

    Background: Little is known about residents of long-term care (LTC) facilities who die of cancer . The authors examined factors among this cohort prognostic of greater acute care use to identify areas for improving support in LTC. Methods: The authors used administrative data representing all...

  • Blood Transfusion Is an Independent Predictor of Mortality after Blunt Trauma. Charles, Anthony; Shaikh, Almaas A.; Walters, Madonna; Huehl, Susan; Pomerantz, Richard // American Surgeon;Jan2007, Vol. 73 Issue 1, p1 

    Allogeneic blood transfusion is associated with increased morbidity and mortality. The authors evaluated the affect of blood transfusion, independent of injury severity on mortality. The authors conducted a retrospective review of all patients, age ≥18 years with blunt injury admitted to...

  • Simplified Alternative to the TRISS Method for Resource-Constrained Settings. Nakahara, Shinji; Ichikawa, Masao; Kimura, Akio // World Journal of Surgery;Mar2011, Vol. 35 Issue 3, p512 

    Background: We developed simple methods of risk adjustment for evaluating the quality of injury care (predicting survival probabilities of the injured) by fully utilizing routinely collected data in injury surveillance and clinical practices. Widely used methods of risk adjustment require...

  • ED Interventions. GREENE, JAN // Trustee;Oct2012, Vol. 65 Issue 9, p10 

    The article narrates how U.S. hospitals implement emergency department (ED) interventions to curb overuse through case management and community support. The Bridge program at Kaweah Delta Hospital in Visalia, California has 4 community outreach workers who work with frequent ED patients while an...

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