A comparison of thoracic CT and abdominal CT for the identification of thoracic blunt trauma

• Published in: The American journal of surgery Vol. 204; no. 6; pp. 927 - 932
• Main Authors: Pinette, William, B.S, Barrios, Cristobal, M.D, Pham, Jacqueline, B.S, Kong, Allen, M.D, Dolich, Matthew, M.D, Lekawa, Michael, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-12-2012; Elsevier; Elsevier Limited
• Subjects: Abdomen; Abdominal; Adult; Biological and medical sciences; Blunt trauma; Chest; Computed tomography; Female; General aspects; Humans; Injuries of the thorax. Foreign bodies. Diseases due to physical agents; Injury Severity Score; Male; Medical research; Medical sciences; Occult; Occult sciences; Physicians; Pneumology; Pneumothorax; Prospective Studies; Radiography; Radiography, Abdominal; Radiography, Thoracic; Respiratory system : syndromes and miscellaneous diseases; Sports injuries; Studies; Surgery; Thoracic; Thoracic Injuries - diagnostic imaging; Thoracic Injuries - etiology; Tomography, X-Ray Computed; Traumas. Diseases due to physical agents; Wounds, Nonpenetrating - diagnostic imaging; Wounds, Nonpenetrating - etiology; Radiography; Chest; Pneumothorax; Blunt trauma; Computed tomography; Thoracic; Abdominal; Occult; Diseases of the osteoarticular system; Thorax trauma; Identification; Hemorrhage; Surgery; Radiodiagnosis; Effusion; Respiratory disease; Exploration; Thorax; Abdomen; Medicine; Treatment; Medical imagery; Pleural disease; Computerized axial tomography; Comparative study
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2012.10.002

Abstract Background In light of current trends to limit radiation exposure and costs, as well as increased traffic safety, computed tomography (CT) may have decreasing value for evaluating patients with blunt trauma. The authors examined the utility of chest x-ray and abdominal CT for identifying clinically significant thoracic blunt trauma. Methods In this prospective study, findings on thoracic CT, abdominal CT, and chest x-ray from trauma patients were compared to assess injury prevalence and relevance to treatment outcomes. Results Four hundred forty-four patients were identified, of whom 76% had no findings. Occult findings had significantly lower Injury Severity Scores. All clinically relevant pneumothoraces and most other injuries could be identified without thoracic CT. Two of 3 aortic abnormalities were suspected from chest x-ray. Conclusions Clinically significant injuries can be identified with abdominal CT and chest x-ray, safely allowing reductions in radiation exposure, hospital stays, and costs by limiting the use of thoracic CT.