Trauma Unit, Department of Surgery, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, The Netherlands.
Br J Surg. 2012 Jan;99 Suppl 1:105-13. doi: 10.1002/bjs.7705.
Computed tomography (CT) of injured patients in the radiology department requires potentially dangerous and time-consuming patient transports and transfers. It was hypothesized that CT in the trauma room would improve patient outcome and workflow.
A randomized trial compared the effect of locating a CT scanner in the trauma room versus the radiology department in two Dutch trauma hospitals. Injured patients aged at least 16 years were assigned randomly to one of these hospitals at the time of transport. The primary outcome measure was the number of non-institutionalized days within the first year after randomization. Subgroup analyses were performed in patients with multiple trauma or severe traumatic brain injury (TBI).
Some 1124 patients were included, of whom 1045 were available for analysis. The median number of non-institutionalized days was 360 days in the intervention group versus 362 days for the control group (P = 0.068). The time from arrival to the first CT imaging was 13 min shorter in the intervention group (36 versus 49 min; P < 0.001). Patient transfers and transports were reduced by more than half in the intervention group. For both multiple trauma (265 patients) and TBI (121) subgroups, differences in mortality and out-of-hospital days favoured the intervention group, but were not statistically significant.
A CT scanner located in the trauma room reduces the time to acquire CT images and improves workflow, but does not lead to substantial improvements in clinical outcomes in a general trauma population. Observed beneficial effects on outcomes in patients with multiple trauma or severe TBI were not statistically significant.
ISRCTN55332315 (http://www.controlled-trials.com).
放射科对受伤患者进行计算机断层扫描（CT）需要进行潜在危险且耗时的患者转运。有人假设在创伤室进行 CT 检查会改善患者的预后和工作流程。
一项随机试验比较了将 CT 扫描仪放置在创伤室与荷兰两家创伤医院放射科的效果。在转运时，将至少 16 岁的受伤患者随机分配到这两家医院之一。主要观察指标是随机分组后第一年无住院天数。对多发伤或严重创伤性脑损伤（TBI）患者进行亚组分析。
共纳入 1124 例患者，其中 1045 例可进行分析。干预组的无住院天数中位数为 360 天，对照组为 362 天（P=0.068）。干预组从到达至首次 CT 成像的时间缩短了 13 分钟（36 分钟对 49 分钟；P<0.001）。干预组患者的转科和转运减少了一半以上。多发伤亚组（265 例）和 TBI 亚组（121 例）中，死亡率和院外天数的差异有利于干预组，但无统计学意义。
在创伤室设置 CT 扫描仪可缩短获得 CT 图像的时间，改善工作流程，但对一般创伤人群的临床结局无明显改善。在多发伤或严重 TBI 患者中观察到的有益效果无统计学意义。
ISRCTN55332315（http://www.controlled-trials.com）。
