• Nathan Banaste, Bérénice Caurier, Flavie Bratan, Jean-François Bergerot, Vivien Thomson, and Ingrid Millet.
• From the Department of Radiology, CHU Centre Léon Bérard, Lyon, France (N.B.); Lyon 1 University, Villeurbanne, France (N.B., B.C.); Department of Emergency Medicine, CH Saint-Joseph Saint-Luc, Lyon, France (B.C.); Imadis Teleradiology, Lyon, France (N.B., F.B., J.F.B., V.T.); and Department of Radiology, CHU Montpellier, Université de Montpellier, 191 Ave du Doyen Gaston Giraud, 34295 Montpellier, France (I.M.).
• Radiology. 2018 Nov 1; 289 (2): 374-383.

AbstractPurpose To determine radiologic and clinical markers predictive of missed injuries at early whole-body CT image interpretation. Materials and Methods For this retrospective study, 2354 consecutive whole-body CT examinations were performed in patients with multiple traumas from 26 hospitals interpreted at a teleradiology center study during on-call period from February 2011 to September 2016. All whole-body CT images were interpreted by the on-call radiologist and reviewed within 12-48 hours by another radiologist to detect missed injury as the standard of reference. The first and review reports of all examinations were retrospectively reviewed. Univariable and multivariable logistic regression with a stepwise selection method were performed to identify clinical and radiologic predictors of missed injury. Results This study included 639 women (27.1%) and 1715 men (72.8%). The median age of men, women, and the entire population was 34 years (age range, 1-96 years). On a per-scan basis, there were 304 (12.9%) missed injuries and 59 (2.5%) were clinically significant. On a per-injury basis, the missed injury rate was 530 of 5979 (8.8%). More than two injured body parts (odds ratio, 1.4 [95% confidence interval: 1.1, 1.8]; P = .01), patient age older than 30 years (odds ratio, 2.8 [95% confidence interval: 2.1, 3.8]; P < .001), and an initial clinical severity class of 1 (odds ratio, 1.9 [95% confidence interval: 1.3, 2.8]; P < .001) were independent predictive factors of missed injury. Conclusion Multiple traumas with more than two injured body parts, age older than 30 years, or an initial clinical severity class of 1 were associated with missed injury at whole-body CT. © RSNA, 2018 Online supplemental material is available for this article. See also the editorial by Novelline in this issue.

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