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The American surgeon · Jan 2006
Comparative StudyThe trauma bay chest radiograph in stable blunt-trauma patients: do we really need it?
- Joao A Lopes, Heidi L Frankel, S Jamal Bokhari, Matthew Bank, Manish Tandon, and Reuven Rabinovici.
- Yale University School of Medicine, Yale New Haven Hospital, New Haven, Connecticut, USA.
- Am Surg. 2006 Jan 1;72(1):31-4.
AbstractThe current study evaluates the need for trauma bay chest radiographs (CXR) in stable blunt-trauma patients who are scheduled for chest computed tomography (CCT). A retrospective review of 157 randomly selected, stable, adult blunt-trauma patients who were admitted to a level I trauma center between 2000 and 2002, who underwent both CXR and CCT (GE Light-Speed Scanner), was performed. Stable patients were defined as unintubated, normotensive (SBP > 100 mm Hg), and without hypoxia (O2 saturation > 90%). No interventions were conducted in the trauma bay based on chest radiograph findings. Among 95 patients with a "normal" CXR, 38 patients (40%) were found on CCT to have traumatic injuries. Among 62 patients with an "abnormal" CXR, 18 (29%) were found to be normal on CCT. Of the remaining 44 patients, 34 had additional findings on CCT. In 32 patients, CCT led to changes in management. CCT was more sensitive in diagnosing thoracic injuries and led to significant changes in management. We feel that CXR could be safely eliminated in favor of CCT in stable blunt-trauma patients.
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