• Mackenzie R Cook, John B Holcomb, Mohammad H Rahbar, Erin E Fox, Louis H Alarcon, Eileen M Bulger, Karen J Brasel, Martin A Schreiber, and PROMMTT Study Group.
• Department of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code L611, Portland, OR 97239, USA. Electronic address: cookmac@ohsu.edu.
• Am. J. Surg. 2015 May 1; 209 (5): 834-40.

BackgroundPositive Focused Assessment with Sonography in Trauma examination and hypotension often indicate urgent surgery. An abdomen/pelvis computed tomography (apCT) may allow less invasive management but the delay may be associated with adverse outcomes.MethodsPatients in the Prospective Observational Multicenter Major Trauma Transfusion study with hypotension and a positive Focused Assessment with Sonography in Trauma (HF+) examination who underwent a CT (apCT+) were compared with those who did not.ResultsOf the 92 HF+ identified, 32 (35%) underwent apCT during initial evaluation and apCT was associated with decreased odds of an emergency operation (odds ratio .11, 95% confidence interval .001 to .116) and increased odds of angiographic intervention (odds ratio 14.3, 95% confidence interval 1.5 to 135). There was no significant difference in 30-day mortality or need for dialysis.ConclusionsAn apCT in HF+ patients is associated with reduced odds of emergency surgery, but not mortality. Select HF+ patients can safely undergo apCT to obtain clinically useful information.Copyright © 2015 Elsevier Inc. All rights reserved.

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