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Chest computed tomography scan alters the management plan in multiple trauma patients with a prior chest X-ray

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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.

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Data availability statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Emergency Medicine Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Bita Soltanpour, Atousa Akhgar & Mohammad Jalili

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  1. Bita Soltanpour
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  2. Atousa Akhgar
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  3. Mohammad Jalili
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Correspondence to Atousa Akhgar.

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The authors have no relevant financial or non-financial interests to disclose.

Ethical approval and informed consent

This retrospective was conducted on available data, therefore, was approved by the ethical committee and received registration number of IR.TUMS.IKHC.REC.1398.112.

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We used the human participants data without any human intervention.

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Soltanpour, B., Akhgar, A. & Jalili, M. Chest computed tomography scan alters the management plan in multiple trauma patients with a prior chest X-ray. Chin J Acad Radiol 6, 82–88 (2023). https://doi.org/10.1007/s42058-022-00110-9

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  • DOI: https://doi.org/10.1007/s42058-022-00110-9

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