Whole-body multislice computed tomography (MSCT) improves trauma care in patients requiring surgery after multiple trauma
ObjectivesWhole-body multislice helical CT becomes increasingly important as a diagnostic tool in patients with multiple injuries. Time gain in multiple-trauma patients who require emergency surgery might improve outcome. The authors hypothesised that whole-body multislice computed tomography (MSCT)...
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| Veröffentlicht in: | Emergency medicine journal : EMJ 2011-04, Vol.28 (4), p.300-304 |
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| creator | Wurmb, T E Quaisser, C Balling, H Kredel, M Muellenbach, R Kenn, W Roewer, N Brederlau, J |
| description | ObjectivesWhole-body multislice helical CT becomes increasingly important as a diagnostic tool in patients with multiple injuries. Time gain in multiple-trauma patients who require emergency surgery might improve outcome. The authors hypothesised that whole-body multislice computed tomography (MSCT) (MSCT trauma protocol) as the initial diagnostic tool reduces the interval to start emergency surgery (tOR) if compared to conventional radiography, combined with abdominal ultrasound and organ-focused CT (conventional trauma protocol). The second goal of the study was to investigate whether the diagnostic approach chosen has an impact on outcome.MethodsThe authors' level 1 trauma centre uses whole-body MSCT for initial radiological diagnostic work-up for patients with suspected multiple trauma. Before the introduction of MSCT in 2004, a conventional approach was used. Group I: data of trauma patients treated with conventional trauma protocol from 2001 to 2003. Group II: data from trauma patients treated with whole-body MSCT trauma protocol from 2004 to 2006.ResultstOR in group I (n=155) was 120 (90–150) min (median and IQR) and 105 (85–133) min (median and IQR) in group II (n=163), respectively (p |
| doi_str_mv | 10.1136/emj.2009.082164 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_858781149</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4018075641</sourcerecordid><originalsourceid>FETCH-LOGICAL-b463t-dc17e9e1d00c091cfa1c23abb18633aa182b22a04b5c1e14a8203381cb2dd493</originalsourceid><addsrcrecordid>eNqFkctv1DAQhyNERUvhzA1Z4sBDytZj5-EcqxUFSllUWMHRcpzZrZckTv1AzX9PSrZ74MJpLM03vxn5S5IXQBcAvDjDbrdglFYLKhgU2aPkBLKSpZQBf3x40_w4eer9jlLIq0w8SY4ZLfJKiPwkGX_e2BbT2jYj6WIbjG-NRqJtN8SADQm2s1unhpuRvPnyfbl-S0w3OPsbPQlOxU4RrRwS05NBBYN98MThbTTO9Fvio9uiG4naBHRz_NDifvBZcrRRrcfn-3qarC_er5cf06uvHz4tz6_SOit4SBsNJVYIDaWaVqA3CjTjqq5BFJwrBYLVjCma1bkGhEwJRjkXoGvWNFnFT5PXc-x09W1EH2RnvMa2VT3a6KXIRSkA_pKv_iF3Nrp-uk1CKej0p5XIJupsprSz3jvcyMGZTrlRApX3TuTkRN47kbOTaeLlPjfWHTYH_kHCBKQzYHzAu0NfuV-yKHmZy9WPpbxYXa-uP19-k3zi3818PW363_Y_GaSlZg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1780021984</pqid></control><display><type>article</type><title>Whole-body multislice computed tomography (MSCT) improves trauma care in patients requiring surgery after multiple trauma</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Wurmb, T E ; Quaisser, C ; Balling, H ; Kredel, M ; Muellenbach, R ; Kenn, W ; Roewer, N ; Brederlau, J</creator><creatorcontrib>Wurmb, T E ; Quaisser, C ; Balling, H ; Kredel, M ; Muellenbach, R ; Kenn, W ; Roewer, N ; Brederlau, J</creatorcontrib><description>ObjectivesWhole-body multislice helical CT becomes increasingly important as a diagnostic tool in patients with multiple injuries. Time gain in multiple-trauma patients who require emergency surgery might improve outcome. The authors hypothesised that whole-body multislice computed tomography (MSCT) (MSCT trauma protocol) as the initial diagnostic tool reduces the interval to start emergency surgery (tOR) if compared to conventional radiography, combined with abdominal ultrasound and organ-focused CT (conventional trauma protocol). The second goal of the study was to investigate whether the diagnostic approach chosen has an impact on outcome.MethodsThe authors' level 1 trauma centre uses whole-body MSCT for initial radiological diagnostic work-up for patients with suspected multiple trauma. Before the introduction of MSCT in 2004, a conventional approach was used. Group I: data of trauma patients treated with conventional trauma protocol from 2001 to 2003. Group II: data from trauma patients treated with whole-body MSCT trauma protocol from 2004 to 2006.ResultstOR in group I (n=155) was 120 (90–150) min (median and IQR) and 105 (85–133) min (median and IQR) in group II (n=163), respectively (p<0.05). Patients of group II had significantly more serious injuries. No difference in outcome data was found. 14 patients died in both groups within the first 30 days; five of these died within the first 24 h.ConclusionA whole-body MSCT-based diagnostic approach to multiple trauma shortens the time interval to start emergency surgery in patients with multiple injuries. Mortality remained unchanged in both groups. Patients of group II were more seriously injured; an improvement of outcome might be assumed.</description><identifier>ISSN: 1472-0205</identifier><identifier>EISSN: 1472-0213</identifier><identifier>DOI: 10.1136/emj.2009.082164</identifier><identifier>PMID: 20659885</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine</publisher><subject>Abdomen ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Airway management ; Algorithms ; Blunt major trauma ; Child ; Child, Preschool ; Contrast agents ; emergency department management ; Emergency medical care ; Female ; Humans ; imaging ; Infant ; Injuries ; Injury Severity Score ; Length of Stay - statistics & numerical data ; Lifesaving ; Male ; management ; Medical imaging ; Middle Aged ; Multiple Trauma - diagnostic imaging ; Multiple Trauma - mortality ; Multiple Trauma - surgery ; Ostomy ; Patients ; Radiography ; Respiration, Artificial - statistics & numerical data ; Retrospective Studies ; Surgery ; Time Factors ; Tomography ; Tomography, Spiral Computed - methods ; Trauma ; Trauma care ; trauma emergency radiology ; trauma management ; Treatment Outcome ; Ultrasonic imaging ; Ultrasonography ; Whole Body Imaging ; whole-body multislice CT</subject><ispartof>Emergency medicine journal : EMJ, 2011-04, Vol.28 (4), p.300-304</ispartof><rights>2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2011 (c) 2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b463t-dc17e9e1d00c091cfa1c23abb18633aa182b22a04b5c1e14a8203381cb2dd493</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://emj.bmj.com/content/28/4/300.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://emj.bmj.com/content/28/4/300.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3183,23550,27901,27902,77342,77373</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20659885$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wurmb, T E</creatorcontrib><creatorcontrib>Quaisser, C</creatorcontrib><creatorcontrib>Balling, H</creatorcontrib><creatorcontrib>Kredel, M</creatorcontrib><creatorcontrib>Muellenbach, R</creatorcontrib><creatorcontrib>Kenn, W</creatorcontrib><creatorcontrib>Roewer, N</creatorcontrib><creatorcontrib>Brederlau, J</creatorcontrib><title>Whole-body multislice computed tomography (MSCT) improves trauma care in patients requiring surgery after multiple trauma</title><title>Emergency medicine journal : EMJ</title><addtitle>Emerg Med J</addtitle><description>ObjectivesWhole-body multislice helical CT becomes increasingly important as a diagnostic tool in patients with multiple injuries. Time gain in multiple-trauma patients who require emergency surgery might improve outcome. The authors hypothesised that whole-body multislice computed tomography (MSCT) (MSCT trauma protocol) as the initial diagnostic tool reduces the interval to start emergency surgery (tOR) if compared to conventional radiography, combined with abdominal ultrasound and organ-focused CT (conventional trauma protocol). The second goal of the study was to investigate whether the diagnostic approach chosen has an impact on outcome.MethodsThe authors' level 1 trauma centre uses whole-body MSCT for initial radiological diagnostic work-up for patients with suspected multiple trauma. Before the introduction of MSCT in 2004, a conventional approach was used. Group I: data of trauma patients treated with conventional trauma protocol from 2001 to 2003. Group II: data from trauma patients treated with whole-body MSCT trauma protocol from 2004 to 2006.ResultstOR in group I (n=155) was 120 (90–150) min (median and IQR) and 105 (85–133) min (median and IQR) in group II (n=163), respectively (p<0.05). Patients of group II had significantly more serious injuries. No difference in outcome data was found. 14 patients died in both groups within the first 30 days; five of these died within the first 24 h.ConclusionA whole-body MSCT-based diagnostic approach to multiple trauma shortens the time interval to start emergency surgery in patients with multiple injuries. Mortality remained unchanged in both groups. Patients of group II were more seriously injured; an improvement of outcome might be assumed.</description><subject>Abdomen</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Airway management</subject><subject>Algorithms</subject><subject>Blunt major trauma</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Contrast agents</subject><subject>emergency department management</subject><subject>Emergency medical care</subject><subject>Female</subject><subject>Humans</subject><subject>imaging</subject><subject>Infant</subject><subject>Injuries</subject><subject>Injury Severity Score</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Lifesaving</subject><subject>Male</subject><subject>management</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>Multiple Trauma - diagnostic imaging</subject><subject>Multiple Trauma - mortality</subject><subject>Multiple Trauma - surgery</subject><subject>Ostomy</subject><subject>Patients</subject><subject>Radiography</subject><subject>Respiration, Artificial - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Time Factors</subject><subject>Tomography</subject><subject>Tomography, Spiral Computed - methods</subject><subject>Trauma</subject><subject>Trauma care</subject><subject>trauma emergency radiology</subject><subject>trauma management</subject><subject>Treatment Outcome</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography</subject><subject>Whole Body Imaging</subject><subject>whole-body multislice CT</subject><issn>1472-0205</issn><issn>1472-0213</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkctv1DAQhyNERUvhzA1Z4sBDytZj5-EcqxUFSllUWMHRcpzZrZckTv1AzX9PSrZ74MJpLM03vxn5S5IXQBcAvDjDbrdglFYLKhgU2aPkBLKSpZQBf3x40_w4eer9jlLIq0w8SY4ZLfJKiPwkGX_e2BbT2jYj6WIbjG-NRqJtN8SADQm2s1unhpuRvPnyfbl-S0w3OPsbPQlOxU4RrRwS05NBBYN98MThbTTO9Fvio9uiG4naBHRz_NDifvBZcrRRrcfn-3qarC_er5cf06uvHz4tz6_SOit4SBsNJVYIDaWaVqA3CjTjqq5BFJwrBYLVjCma1bkGhEwJRjkXoGvWNFnFT5PXc-x09W1EH2RnvMa2VT3a6KXIRSkA_pKv_iF3Nrp-uk1CKej0p5XIJupsprSz3jvcyMGZTrlRApX3TuTkRN47kbOTaeLlPjfWHTYH_kHCBKQzYHzAu0NfuV-yKHmZy9WPpbxYXa-uP19-k3zi3818PW363_Y_GaSlZg</recordid><startdate>20110401</startdate><enddate>20110401</enddate><creator>Wurmb, T E</creator><creator>Quaisser, C</creator><creator>Balling, H</creator><creator>Kredel, M</creator><creator>Muellenbach, R</creator><creator>Kenn, W</creator><creator>Roewer, N</creator><creator>Brederlau, J</creator><general>BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RQ</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20110401</creationdate><title>Whole-body multislice computed tomography (MSCT) improves trauma care in patients requiring surgery after multiple trauma</title><author>Wurmb, T E ; Quaisser, C ; Balling, H ; Kredel, M ; Muellenbach, R ; Kenn, W ; Roewer, N ; Brederlau, J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b463t-dc17e9e1d00c091cfa1c23abb18633aa182b22a04b5c1e14a8203381cb2dd493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Abdomen</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Airway management</topic><topic>Algorithms</topic><topic>Blunt major trauma</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Contrast agents</topic><topic>emergency department management</topic><topic>Emergency medical care</topic><topic>Female</topic><topic>Humans</topic><topic>imaging</topic><topic>Infant</topic><topic>Injuries</topic><topic>Injury Severity Score</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Lifesaving</topic><topic>Male</topic><topic>management</topic><topic>Medical imaging</topic><topic>Middle Aged</topic><topic>Multiple Trauma - diagnostic imaging</topic><topic>Multiple Trauma - mortality</topic><topic>Multiple Trauma - surgery</topic><topic>Ostomy</topic><topic>Patients</topic><topic>Radiography</topic><topic>Respiration, Artificial - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Time Factors</topic><topic>Tomography</topic><topic>Tomography, Spiral Computed - methods</topic><topic>Trauma</topic><topic>Trauma care</topic><topic>trauma emergency radiology</topic><topic>trauma management</topic><topic>Treatment Outcome</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography</topic><topic>Whole Body Imaging</topic><topic>whole-body multislice CT</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wurmb, T E</creatorcontrib><creatorcontrib>Quaisser, C</creatorcontrib><creatorcontrib>Balling, H</creatorcontrib><creatorcontrib>Kredel, M</creatorcontrib><creatorcontrib>Muellenbach, R</creatorcontrib><creatorcontrib>Kenn, W</creatorcontrib><creatorcontrib>Roewer, N</creatorcontrib><creatorcontrib>Brederlau, J</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Career & Technical Education Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Emergency medicine journal : EMJ</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wurmb, T E</au><au>Quaisser, C</au><au>Balling, H</au><au>Kredel, M</au><au>Muellenbach, R</au><au>Kenn, W</au><au>Roewer, N</au><au>Brederlau, J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Whole-body multislice computed tomography (MSCT) improves trauma care in patients requiring surgery after multiple trauma</atitle><jtitle>Emergency medicine journal : EMJ</jtitle><addtitle>Emerg Med J</addtitle><date>2011-04-01</date><risdate>2011</risdate><volume>28</volume><issue>4</issue><spage>300</spage><epage>304</epage><pages>300-304</pages><issn>1472-0205</issn><eissn>1472-0213</eissn><abstract>ObjectivesWhole-body multislice helical CT becomes increasingly important as a diagnostic tool in patients with multiple injuries. Time gain in multiple-trauma patients who require emergency surgery might improve outcome. The authors hypothesised that whole-body multislice computed tomography (MSCT) (MSCT trauma protocol) as the initial diagnostic tool reduces the interval to start emergency surgery (tOR) if compared to conventional radiography, combined with abdominal ultrasound and organ-focused CT (conventional trauma protocol). The second goal of the study was to investigate whether the diagnostic approach chosen has an impact on outcome.MethodsThe authors' level 1 trauma centre uses whole-body MSCT for initial radiological diagnostic work-up for patients with suspected multiple trauma. Before the introduction of MSCT in 2004, a conventional approach was used. Group I: data of trauma patients treated with conventional trauma protocol from 2001 to 2003. Group II: data from trauma patients treated with whole-body MSCT trauma protocol from 2004 to 2006.ResultstOR in group I (n=155) was 120 (90–150) min (median and IQR) and 105 (85–133) min (median and IQR) in group II (n=163), respectively (p<0.05). Patients of group II had significantly more serious injuries. No difference in outcome data was found. 14 patients died in both groups within the first 30 days; five of these died within the first 24 h.ConclusionA whole-body MSCT-based diagnostic approach to multiple trauma shortens the time interval to start emergency surgery in patients with multiple injuries. Mortality remained unchanged in both groups. Patients of group II were more seriously injured; an improvement of outcome might be assumed.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine</pub><pmid>20659885</pmid><doi>10.1136/emj.2009.082164</doi><tpages>5</tpages></addata></record> |
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| subjects | Abdomen Adolescent Adult Aged Aged, 80 and over Airway management Algorithms Blunt major trauma Child Child, Preschool Contrast agents emergency department management Emergency medical care Female Humans imaging Infant Injuries Injury Severity Score Length of Stay - statistics & numerical data Lifesaving Male management Medical imaging Middle Aged Multiple Trauma - diagnostic imaging Multiple Trauma - mortality Multiple Trauma - surgery Ostomy Patients Radiography Respiration, Artificial - statistics & numerical data Retrospective Studies Surgery Time Factors Tomography Tomography, Spiral Computed - methods Trauma Trauma care trauma emergency radiology trauma management Treatment Outcome Ultrasonic imaging Ultrasonography Whole Body Imaging whole-body multislice CT |
| title | Whole-body multislice computed tomography (MSCT) improves trauma care in patients requiring surgery after multiple trauma |
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