Emergency Radiology

, Volume 26, Issue 1, pp 5–13 | Cite as

Post-mortem computed tomography improves completeness of the trauma registry: a single institution experience

  • Scott D. SteenburgEmail author
  • Tracy Spitzer
  • Amy Rhodes
Original Article



To describe our institutional experience with post-mortem computed tomography (PMCT) and its impact on decedent injury severity score (ISS) and to assess the adequacy of emergently placed support medical devices.


Over a 5-year period, patients who died at or soon after arrival and have physical exam findings inconsistent with death were candidates for inclusion. Whole body CT was performed without contrast with support medical devices left in place. ISS was calculated with and without the PMCT findings. PMCT results were compared to autopsy findings, if performed. The location of support medical devices was documented.


A total of 38 decedents underwent PMCT, including 53.1% males and a mean age of 42.0 years. Pre-PMCT ISS based on physical exam findings alone was 5.2 (range 0–25), including 16 with ISS = 0. Post-PMCT ISS using the additional imaging data was 50.3 (range 21–75), including 15 with ISS = 50 or greater. Nearly half (47.4%) had at least one support medical device that was either malpositioned or suboptimally positioned, including 26.3% with malpositioned airway devices, 10.3% with malpositioned intra-osseous catheters, and 100% with malpositioned decompressive needle thoracotomies.


PMCT adds value in identifying injuries that otherwise may have gone undetected in lieu of a formal autopsy, thus creating a more complete trauma registry. The identification of malpositioned support lines and tubes allows for educational feedback to the first responders and trainees. Institutions with a low formal autopsy rate for trauma victims may benefit from developing a PMCT program.


Trauma Mortality Post-mortem CT 


Compliance with ethical standards

Conflict of interest

Scott D. Steenburg, MD

- International Business Machines – Institutional joint study agreement

- Department of the Army – research grant support (Federal award number: W81XWH-16-2-0060)

For all other authors, there are no conflicts of interest.


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Copyright information

© American Society of Emergency Radiology 2018

Authors and Affiliations

  • Scott D. Steenburg
    • 1
    Email author
  • Tracy Spitzer
    • 2
  • Amy Rhodes
    • 1
  1. 1.Department of Radiology and Imaging Sciences, Division of Emergency RadiologyIndiana University School of Medicine and Indiana University Health Methodist HospitalIndianapolisUSA
  2. 2.Department of Trauma and Critical Care SurgeryIndiana University School of Medicine and Indiana University Health Methodist HospitalIndianapolisUSA

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