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. 2017 Feb;43(1):35-42.
doi: 10.1007/s00068-016-0711-4. Epub 2016 Jul 19.

Indications for total-body computed tomography in blunt trauma patients: a systematic review

K Treskes  1 , T P Saltzherr  2 , J S K Luitse  2 , L F M Beenen  3 , J C Goslings  2
Affiliations

Indications for total-body computed tomography in blunt trauma patients: a systematic review

K Treskes et al. Eur J Trauma Emerg Surg. 2017 Feb.

Abstract

Purpose: Total-body CT scanning (TBCT) could improve the initial in-hospital evaluation of severe trauma patients. Indications for TBCT, however, differ between trauma centers, so more insight in how to select patients that could benefit from TBCT is required. The aim of this review was to give an overview of currently used indications for total-body CT in trauma patients and to describe mortality and Injury Severity Scores of patient groups selected for TBCT.

Methods: A systematic review was performed by searching MEDLINE and Embase databases. Studies evaluating or describing criteria for selection of patients with potentially severe injuries for TBCT during initial trauma care were included. Also, studies comparing total-body CT during the initial assessment of injured patients with conventional imaging and selective CT in specific patient groups were included.

Results: Thirty eligible studies were identified. Three studies evaluated indications for TBCT in trauma with divergent methods. Combinations of compromised vital parameters, severe trauma mechanisms and clinical suspicion on severe injuries are often used indications; however, clinical judgement is used as well. Studies describing TBCT indications selected patients in different ways and were difficult to compare regarding mortality and injury severity.

Conclusions: Indications for TBCT in trauma show a wide variety in structure and cut-off values for vital parameters and trauma mechanism dimensions. Consensus on indications for TBCT in trauma is lacking.

Keywords: Computed tomography; Multiple trauma; Total-body CT; Whole body imaging; Wounds and injuries.

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Conflict of interest statement

Kaij Treskes, Teun Peter Saltzherr, Jan Luitse, Ludo Beenen, and Carel Goslings declare that they have no conflict of interest. Ethical standard This article does not contain any studies with human participants or animals performed by any of the authors.

Figures

Fig. 1
Fig. 1
Flowchart for the selection of studies
See this image and copyright information in PMC

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