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Role of preoperative CT imaging in penetrating thoraco-abdominal injuries: A multicenter study of urban trauma centers
Journal article   Open access   Peer reviewed

Role of preoperative CT imaging in penetrating thoraco-abdominal injuries: A multicenter study of urban trauma centers

Madison Harris, Toba Bolaji, Steven DiStefano, Keshab Subedi, John Getchell, Kristen Knapp, Aara Sheth, Tanya Egodage, Zaheer Faizi, Joseph Morales, …
The American journal of surgery, v 239, 116032
Jan 2025
DOI: https://doi.org/10.1016/j.amjsurg.2024.116032
PMID: 39471731
url
https://pmc.ncbi.nlm.nih.gov/articles/PMC11649440/pdf/nihms-2032513.pdfView
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Abstract

CT scan Penetrating trauma Preoperative CT
Management of penetrating thoracoabdominal (PTA) injuries with signs of hemorrhage have warranted operative intervention but improved imaging capabilities have redefined interventions required. We examined outcomes of hemodynamically stable patients undergoing preoperative CT imaging with the hypothesis that CT imaging would decrease OR time without delaying OR arrival. A retrospective multicenter study was performed amongst four urban trauma centers examining hemodynamically stable patients with PTA injuries requiring operative intervention from January 2017–December 2021. The primary outcome was OR time. Secondary outcomes included length of stay (LOS), ICU LOS, and mortality. A multivariable logistic regression with random intercept for trauma center was fit to assess whether preoperative CT affected time in the OR. Of 534 hemodynamically stable patients with penetrating injuries, 322 (60.3 ​%) received preoperative CT. The median time in OR were 130 (IQR: 84,180) and 140 (IQR: 100, 180) minutes for patients with and without preoperative CT, respectively. Median time to OR was 68 (IQR: 47, 110) and 26 (IQR 17,38) minutes in patients with and without preop CT, respectively. Median ICU LOS were 0 vs 1 day, the median hospital LOS were 7 vs 8 days for patients with and without pre-op imaging respectively. The multivariable model showed that obtaining a pre-op CT scanning was not independently associated with time spent in OR. (Adjusted OR:0.94; 95 ​% CI: 0.85, 1.04). In patients with PTA injuries and hemodynamic stability, preoperative CT scanning was not associated with decreased OR time, postoperative complications, or mortality. •CT has significantly changed the paradigm in management of penetrating injuries.•Preoperative CT appears safe & useful in stable patients with penetrating injuries.•Median OR was similar amongst patients who did and did not receive preoperative CT.•CT lends to thoughtful operative planning and thorough postoperative workups.

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This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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