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Positive Whole-Body CT Can Detect but Not Eliminate Trauma

Close monitoring and clinical follow-up of patients with traumatic injuries still advised

TUESDAY, March 6 (HealthDay News) -- For assessing severe trauma, single-pass whole-body computed tomography (CT), or pan-scanning, can detect, but not definitively exclude, the presence of injuries, according to a study published online March 5 in CMAJ, the journal of the Canadian Medical Association.

Dirk Stengel, M.D., Ph.D., of the Unfallkrankenhaus in Berlin, and colleagues analyzed data from 982 patients with suspected severe injuries who underwent single-pass pan-scanning at a trauma center. The scans were independently evaluated by two reviewers who analyzed the injuries to five body regions and compared the results with a synopsis of hospital charts, ensuing imaging, and interventional procedures. The median length of follow-up was 39 days (interquartile range, 7 to 490), and 474 patients underwent a definitive reference test.

The researchers found that 1,756 injuries were detected in the patients scanned. An Injury Severity Score of greater than 15 was seen in 360 patients. The sensitivity and specificity of the initial pan-scan were 84.6 and 98.9 percent, respectively, for head and neck injuries; 79.6 and 99.1 percent for facial injuries; 86.7 and 98.9 percent for thoracic injuries; 85.7 and 97.5 percent for abdominal injuries; and 86.2 and 99.8 percent for pelvic injuries. Seventy missed injuries were seen in 62 patients, indicating a 6.3 percent residual risk.

"The positive results of trauma pan-scans are conclusive but negative results require subsequent confirmation," the authors write. "The pan-scan algorithms reduce, but do not eliminate, the risk of missed injuries, and they should not replace close monitoring and clinical follow-up of patients with major trauma."

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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