Whole-Body Computed Tomography for Polytrauma Patients in the Emergency Department: Recommended or Unnecessary Radiation

Abstract

Background: Whole-body computed tomography (WBCT) is one of the standard non-invasive tests for trauma patients, to avoid the overuse of the WBCT and unnecessary radiation to the patients, a combination of evidence-based indications, approved guidelines and the clinical decision should be used. This study was done to emphasize on limitation of unnecessary WBCT following international or local criteria along with clinical assessment and decision without compromising the patient’s safety. Methodology: This study was performed in King Fahad Hospital-Emergency Department in Albaha region in the kingdom of Saudi Arabia, the study was done in the period from January 2020 to December 2020, the study population is polytrauma patients of the age of 18 years old and above, it is a descriptive, retrospective database analysis of 233 patients diagnosed with polytrauma in the emergency department, all patients were received by emergency physicians and trauma team members, where they received their initial management and stabilized then sent to the Radiology department for WBCT according to the order by senior ED physician or on-call surgeon who is a member of the trauma team, Informed consent was taken according to the hospital protocol. Results: Whole-body CT was carried out on 233 polytrauma patients arriving at the emergency department, the outcome of the WBCT was n ≈ 70 (30%) were negative findings, n ≈ 87 (37.3%) they have a single organ involved in trauma and n ≈ 76 (32.7%) the reports came with multiple organs (more than 1) involved in trauma. Conclusion: This study showed slight overuse of WBCT in our facility, 30% of reports came of negative findings. The combination of senior’s clinical decisions, application of appropriate local or international evidence-based criteria for performing WBCT will lead to avoiding a good number of unnecessary WBCT, radiation exposure, and side effects of contrast materials besides reducing the costs for the health economic system.