• Colomb Medica · Mar 2020

    Observational Study

    Implementation of a new Single-Pass Whole-Body Computed Tomography Protocol: Is it safe, effective and efficient in patients with severe trauma?

    • Carlos Ordoñez, Carlos García, Michael W Parra, Edison Angamarca, Mónica Guzmán-Rodríguez, Claudia P Orlas, Juan Pablo Herrera-Escobar, Erika Rincón, Juan José Meléndez, Jose Julián Serna, Natalia Padilla, Ana Milena Del Valle, Alberto F García, and Alfonso Holguín.
    • Universidad del Valle, Facultad de Salud, Escuela de Medicina, Sección de Cirugía de Trauma y EmergenciasCali, Colombia.
    • Colomb Medica. 2020 Mar 30; 51 (1): e4224.

    PurposeThe objective of this study was to evaluate the implementation of a new single-pass whole-body computed tomography Protocol in the management of patients with severe trauma.MethodsThis was a descriptive evaluation of polytrauma patients who underwent whole-body computed tomography. Patients were divided into three groups: 1. Blunt trauma hemodynamically stable 2. Blunt trauma hemodynamically unstable and 3. Penetrating trauma. Demographics, whole-body computed tomography parameters and outcome variables were evaluated.ResultsWere included 263 patients. Median injury severity score was 22 (IQR: 16-22). Time between arrival to the emergency department and completing the whole-body computed tomography was under 30 minutes in most patients [Group 1: 28 minutes (IQR: 14-55), Group 2: 29 minutes (IQR: 16-57), and Group 3: 31 minutes (IQR: 13-50; p= 0.96)]. 172 patients (65.4%) underwent non-operative management. The calculated and the real survival rates did not vary among the groups either [Group 1: TRISS 86.4% vs. real survival rate 85% (p= 0.69); Group 2: TRISS 69% vs. real survival rate 74% (p= 0.25); Group 3: TRISS 93% vs. real survival rate 87% (p= 0.07)].ConclusionThis new single-pass whole-body computed tomography protocol was safe, effective and efficient to decide whether the patient with severe trauma requires a surgical intervention independently of the mechanism of injury or the hemodynamic stability of the patient. Its use could also potentially reduce the rate of unnecessary surgical interventions of patients with severe trauma including those with penetrating trauma.Copyright © 2020 Colombia Medica.

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