Chest Computed Tomography Scan Alters the Management Plan in Multiple Trauma Patients With a Prior Chest X-Ray Publisher



Soltanpour B¹ ; Akhgar A¹ ; Jalili M¹ Show Affiliations
Source: Chinese Journal of Academic Radiology Published:2023

Abstract

Objective: Computed tomography (CT) scanning of the chest is increasingly utilized to evaluate thoracic injuries in multiple trauma (MT) patients. Studies exploring the effects of chest CT scanning on the patient care and outcome of MT victims compared to chest X-ray (CXR) reported conflicting results. Hereby, researchers sought to investigate the therapeutic plan alteration rate in MT patients after obtaining a chest CT scan. Methods: 117 MT patients who had obtained a CXR before undergoing chest CT scanning were included in the study. Researchers extracted demographic characteristics, mechanisms of trauma, physical examination and imaging findings, and a list of diagnostic and therapeutic interventions from the patients' medical records. The rate of therapeutic plan alteration following chest CT scanning was then calculated. Results: Road traffic accident was the most common mechanism of injury. CXR failed to identify any positive findings in 72.6% of the patients, while 59% had normal chest CT scans. Chest CT scan detected a mean of 0.42 (SD = 1.43) and 2.78 (SD = 1.28) new findings in each patient with normal and positive CXR, respectively. Patients having at least one new finding in chest CT scan more frequently received therapeutic interventions. There was a statistically significant alteration of the management plan between patients with or without new findings in chest CT scan. Conclusion: Although the benefits of chest CT scanning are undoubted in some instances, not all of the previous studies argue in favor of implementing routine chest CT scanning in first-line care of MT patients. Further research is required to unify the inconsistent results previously reported in similar studies. © 2022, The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd.