Non-traumatic incidental findings in patients undergoing whole-body computed tomography at initial emergency admission.

Kroczek, Eduard K; Wieners, Gero; Steffen, Ingo; Lindner, Tobias; Streitparth, Florian; Hamm, Bernd; Maurer, Martin (2017). Non-traumatic incidental findings in patients undergoing whole-body computed tomography at initial emergency admission. Emergency medicine journal, 34(10), pp. 643-646. BMJ Publishing Group 10.1136/emermed-2016-205722

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OBJECTIVE To evaluate the number, localisation and importance of non-traumatic incidental findings (IFs) in patients with suspected or obvious multiple trauma undergoing whole-body CT (WBCT) in a level-1 trauma centre. METHODS Between January 2009 and December 2013, a total of 2440 patients with trauma undergoing WBCT at admission to a level-1 trauma centre of a university hospital were retrospectively analysed, through imaging IFs unrelated to trauma with the radiological reports. All IFs were grouped into four categories according to their clinical relevance. Category 1: urgent treatment or further clarification needed; category 2: further examination and follow-up within 3-6 months required; category 3: findings with no immediate consequences for the treatment of the patient but of potential relevance in the future; category 4: harmless findings. RESULTS Altogether, 5440 IFs in 2440 patients (1735 male, 705 female; mean age 45.1 years) were documented. In 204 patients (8.4%) urgent category 1 findings were reported, 766 patients (31.4%) had category 2 findings, 1236 patients (50.7%) had category 3 findings and 1173 patients (48.1%) had category 4 findings. Most IFs were detected in the abdomen/pelvis (42.5%). 602 (24.7%) of the patients had no IFs. CONCLUSIONS WBCT scans of unrelated trauma patients demonstrate a high rate of IF. A substantial percentage (8.4%) of patients had urgent category 1IFs and a high percentage (31.4%) had category 2 IFs requiring a follow-up. This high number of patients with polytrauma undergoing WBCT, having IFs of high relevance, poses a major challenge for the level-1 trauma centre in the acute and postacute management of these patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Maurer, Martin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1472-0205

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Nicole Rösch

Date Deposited:

21 Feb 2018 09:22

Last Modified:

27 Oct 2019 15:17

Publisher DOI:

10.1136/emermed-2016-205722

PubMed ID:

28130347

Uncontrolled Keywords:

CT/MRI emergency department management epidemiology imaging major incidents major trauma management non-traumatic problems

BORIS DOI:

10.7892/boris.101490

URI:

https://boris.unibe.ch/id/eprint/101490

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