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KMID : 0360720100230020089
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Journal of the Korean Society Traumatology
2010 Volume.23 No. 2 p.89 ~ p.95
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Necessity for a Whole-body CT Scan in Alert Blunt Multiple Trauma Patients
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Mun You-Ho
Kim Yun-Jeong
Shin Su-Jeong
Park Dong-Chan
Park Sin-Ryul
Ryoo Hyun-Wook
Seo Kang-Suk
Park Jeong-Bae
Chung Jae-Myung
Bae Ji-Hye
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Abstract
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Purpose: Whole-body CT is a very attractive diagnostic tool to clinicians, especially, in trauma. It is generally accepted that trauma patients who are not alert require whole-body CT. However, in alert trauma patients, the usefulness is questionable.
Methods: This study was a retrospective review of the medical records of 146 patients with blunt multiple trauma who underwent whole body CT scanning for a trauma workup from March 1, 2008 to February 28, 2009. We classified the patients into two groups by patients’ mental status (alert group: 110 patients, not-alert group: 36 patients). In the alert group, we compared the patients’ evidence of injury (present illness, physical examination, neurological examination) with the CT findings.
Results: One hundred forty six(146) patients underwent whole-body CT. The mean age was years. One hundred four (104, 71.2%) were men, and the injury severity score was . In the not-alert group, the ratios of abnormal CT findings were relatively high: head 23/36(63.9%), neck 3/6(50.0%), chest 16/36(44.4%) and abdomen 9/36(25%). In the alert group, patients with no evidence of injury were rare (head 1, chest 6 and abdomen 2). Nine(9) patients did not need any intervention or surgery.
Conclusion: Whole-body CT has various disadvantages, such as radiation, contrast induced nephropathy and high medical costs. In multiple trauma patients, if they are alert and have no evidence of injury, they rarely have abnormal CT findings, and mostly do not need invasive treatment. Therefore, we should be cautious in performing whole-body CT in alert multiple trauma patients.
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KEYWORD
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Multiple Trauma, Computed tomography, Radiation injuries
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