Sierink Joanne C, Saltzherr Teun P, Edwards Michael J R, Beuker Benn J A, Patka Peter, Goslings J C Carel
Academisch Medisch Centrum, afd. Chirurgie, Trauma-unit, Amsterdam, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(30):A4897.
Immediate total body computed tomography (CT) scanning has become important in the early diagnostic phase of trauma care because of its high diagnostic accuracy. However, literature provides limited evidence whether immediate total body CT leads to better clinical outcome then conventional radiographic imaging supplemented with selective CT scanning in trauma patients. The aim of the REACT-2 trial is to determine the value of immediate total body CT scanning in trauma patients.
The REACT-2 trial is an international, multicenter randomized clinical trial.
All participating trauma centers have a multi-slice CT scanner located in the trauma room or at the Emergency Department (ED). All adult, non-pregnant, severely injured trauma patients according to predefined criteria will be included. The intervention group will receive a contrast-enhanced total body CT scan (head to pelvis) during the primary survey. The control group will be evaluated according to local conventional trauma imaging protocols (based on ATLS guidelines) supplemented with selective CT scanning. Primary outcome will be in-hospital mortality. Secondary outcomes are differences in mortality and morbidity during the first year post trauma, several trauma work-up time intervals, radiation exposure, general health and quality of life at 6 and 12 months post trauma and cost-effectiveness.
The REACT-2 trial is the first multicenter randomized clinical trial that will provide evidence on the value of immediate total body CT scanning during the primary survey of severely injured trauma patients.
由于其高诊断准确性，即时全身计算机断层扫描（CT）在创伤护理的早期诊断阶段已变得至关重要。然而，关于即时全身CT扫描与传统X线成像辅以选择性CT扫描相比，是否能为创伤患者带来更好的临床结局，文献提供的证据有限。REACT - 2试验的目的是确定即时全身CT扫描在创伤患者中的价值。
REACT - 2试验是一项国际多中心随机临床试验。
所有参与的创伤中心在创伤室或急诊科均配备多层CT扫描仪。所有符合预定义标准的成年、非妊娠、重伤创伤患者将被纳入。干预组将在初次评估期间接受增强型全身CT扫描（从头部到骨盆）。对照组将根据当地传统创伤成像方案（基于ATLS指南）辅以选择性CT扫描进行评估。主要结局指标将是住院死亡率。次要结局指标包括创伤后第一年的死亡率和发病率差异、多个创伤检查时间间隔、辐射暴露、创伤后6个月和12个月时的总体健康状况和生活质量以及成本效益。
REACT - 2试验是首个多中心随机临床试验，将为重伤创伤患者初次评估期间即时全身CT扫描的价值提供证据。
