Silver Trauma: Is whole body CT warranted in low impact trauma.

IF 1.8 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Mark Thomas Macmillan, Rachael Kirkbride, Hui Yen Teh, James Bott, Charlotte Algeo, Christopher Hay, Gregor J A Stenhouse
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引用次数: 0

Abstract

Objectives: Trauma in the Elderly is associated with high mortality. Elderly people who have suffered low impact trauma, such as fall from standing (FFS) are believed still to be at high risk of injury. Whole-body trauma CT (WBCT) is increasingly used to image such people, to prevent missing injuries which are not detected clinically. This study aims to assess the utility of WBCT in assessing elderly people who have suffered FFS.

Methods: Over a two-year period in a single health board, data was collected retrospectively for all patients that underwent WBCT. Data was collected on the mechanism, pattern of injury and outcomes including 30-day mortality using clinical records. Comparison was made between pre-CT clinical suspicion and injury found on WBCT to identify discrepancies.

Results: In total 460 patients were included in this study. Compared with FFS, fall from more than standing was associated with higher adjusted odds of having an injury out with zone of clinical suspicion (AOR 2.80 95%CI 1.23-7.28 p = 0.021). There was no significant difference in 30-day mortality between patients who had an injury on WBCT and those without.

Conclusions: FFS is associated with a reduced risk of injury out with areas of clinical concern when compared with fall from greater than standing. As such, a targeted approach to CT scanning in these patients could be considered.

Advances in knowledge: This study challenges the current prevailing dogma for the requirement of WBCT in elderly people who suffer FFS, providing evidence that such people have a low risk of injuries out with areas of clinical suspicion.

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来源期刊
British Journal of Radiology
British Journal of Radiology 医学-核医学
CiteScore
5.30
自引率
3.80%
发文量
330
审稿时长
2-4 weeks
期刊介绍: BJR is the international research journal of the British Institute of Radiology and is the oldest scientific journal in the field of radiology and related sciences. Dating back to 1896, BJR’s history is radiology’s history, and the journal has featured some landmark papers such as the first description of Computed Tomography "Computerized transverse axial tomography" by Godfrey Hounsfield in 1973. A valuable historical resource, the complete BJR archive has been digitized from 1896. Quick Facts: - 2015 Impact Factor – 1.840 - Receipt to first decision – average of 6 weeks - Acceptance to online publication – average of 3 weeks - ISSN: 0007-1285 - eISSN: 1748-880X Open Access option
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