Journal article
Is clinician assessment accurate or is routine pan-body CT needed in the stable intoxicated trauma patient?
The American journal of surgery, v 218(4), pp 755-759
Oct 2019
PMID: 31351577
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
We sought to determine if clinician suspicion of injury was useful in predicting injuries found on pan-body computed tomography (PBCT) in clinically intoxicated patients.
We prospectively enrolled awake, intoxicated patients with low-energy mechanism of injury. For each of four body regions (head/face, neck, thorax and abdomen/pelvis), clinician suspicion for injury was recorded as "low index" or "more than a low index". The reference standard was the presence of any pre-defined significant finding (SF) on CT. Sensitivity, specificity, positive (LR+) and negative (LR-) likelihood ratios were calculated.
Enrollment of 103 patients was completed. Sensitivity, specificity, LR+ and LR-for clinician index of suspicion were: 56%, 68%, 1.75, 0.64 (head/face), 50%, 92%, 6.18, 0.54 (neck), 10%, 96%, 2.60, 0.94 (thorax) and 67%, 93%, 9.56, 0.36 (abdomen/pelvis).
Clinician judgement was most useful to guide need for CT imaging in the neck and abdomen/pelvis. Routine PBCT may not be necessary.
For awake, stable intoxicated patients after falls and assaults, clinician index of suspicion was most useful to guide the need for CT imaging in the neck and abdomen/pelvis. Our findings support selective use of CT if the index of suspicion is low. Routine PBCT may not be necessary.
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Details
- Title
- Is clinician assessment accurate or is routine pan-body CT needed in the stable intoxicated trauma patient?
- Creators
- Shannon Marie Foster - Reading HospitalAlison Muller - Reading HospitalJeremy Conklin - Reading HospitalVicente Cortes - Reading HospitalForrest B Fernandez - Reading HospitalThomas A Geng, Jr - Reading HospitalEugene F Reilly - Reading HospitalAdam Sigal - Reading HospitalAdrian W Ong - Reading Hospital
- Publication Details
- The American journal of surgery, v 218(4), pp 755-759
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000487856400016
- Scopus ID
- 2-s2.0-85069715112
- Other Identifier
- 991022020636204721
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- Web of Science research areas
- Surgery