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Whole body CT can increase survival

Performing full-body CTs in the shock room increases the chance of survival

07/25/2013

Those who are admitted to the emergency room after an accident usually need quick help, especially with seriously injured people, no time must be lost. But despite all the hustle and bustle in the shock room, the implementation of whole-body CTs seems to be a sensible measure. Thus, a study by the Technical University of Munich concludes that such an investigation can provide a significant increase in the chances of survival.

Smooth process in shock room indispensable
Once a patient has been admitted to the trauma room of a hospital, a team of physicians, nurses, and radiology professionals will seek to stabilize or restore vital signs to the injured or even life-threatening patients. In addition, life-saving operations can also be performed before transfer to the intensive care unit or operating room for further operations after initial care. All processes and tasks have been precisely planned and defined beforehand - which is indispensable for a smooth process in such a stressful situation.

Locate and precisely treat bleeding using whole-body CT
Every minute counts in the shock room. Now scientists from the Klinikum rechts der Isar of the Technische Universität München have published an evaluation of the „trauma registry“ The German Society of Traumatology (DGU) and thereby gained interesting findings. Accordingly, physicians should use in the first care of injured patients in particular the whole-body CT - because such a recording increase the chance of survival significantly. The reason: With the help of computed tomography, for example, severely bleeding injuries could be accurately localized and precisely treated, according to the researchers around accident surgeon Stefan Huber-Wagner in the specialist magazine „Plos One“.

Survival through whole-body CT more than 25 percent higher
Based on the analysis of the data, the researchers were able to show for the first time that even the chances of survival of the severely injured were more than 25 percent higher with a whole-body CT. Correspondingly, persons with unstable circulation could also benefit from the procedure, because in severe cases, this has usually been foregone so as not to lose any time until the emergency operation.

Benefit already proven for patients without circulatory shock
In their study, the scientists examined the data of 16,719 severely injured patients from hospitals in Germany, Austria, Switzerland, Belgium and Slovenia. The researchers compared, on the one hand, the expected and actual mortality rates of patients who had received whole-body CT and the mortality rates of those who had not used the procedure. In addition, the scientists differentiated into patients with severe circulatory shock, with moderate circulatory shock and patients without shock, with the benefit of CT being already proven in studies for the third group.

Evaluation shows advantages of whole-body computed tomography
So far, this was different for patients of the other two groups, because here was largely medical consensus that X-rays of the chest, pelvis and cervical spine, an ultrasound examination of the abdomen and a clinical examination would be sufficient. However, in many cases it appears to be different: In 9,233 patients (55 percent) after admission to the clinic, a whole-body CT scan was performed, which took three to six minutes on average. The result: „Based on the analysis of 16,719 patients, those who had been examined during whole-cell CT abdominal trauma showed a significantly better survival rate compared to those who had not received whole-body CT“, said the members of the research group „polytrauma“ in the magazine „Plos One“. In addition, have shown through the study, „that the benefit of whole-body computed tomography during early resuscitation was similar in patients with moderate and severe circulatory shocks compared to those without circulatory shock“, the researchers continue.

Temporal investment apparently without negative effect
The „lost“ Time, which had claimed the procedure, apparently did not affect it negatively: „If, thanks to the examination, we know the patient's complete pattern of injury, we can do much more targeted therapy, "said Dr. Stefan Huber-Wagner „Mirror online“. In addition, injuries that are responsible for the unstable circulation, could be quickly detected - but it is in any case subsequently important to quickly create a meaningful treatment plan.

DGU demands 24-hour availability of a full-body CT near the trauma area
Nonetheless, the researchers recommend caution, as they believe that only treatment centers should perform full-body CTs on people with unstable circulation who have adequate technical equipment and specialized staff. Otherwise, according to Huber-Wagner, such a treatment could actually be dangerous. Accordingly, the expert assumes that in the future shock rooms will be equipped more and more with increasingly powerful computer tomographs. This would also meet the concerns of the German Society for Traumatology - because, according to Huber-Wagner „The 24-hour availability of full-body computed tomography close to the trauma area is already being demanded within the framework of the trauma network formation initiated by the DGU for a transregional or regional trauma center.“ (No)