Wulffeld S, Rasmussen L S, Højlund Bech B, Steinmetz J
Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Diagnostic Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Acta Anaesthesiol Scand. 2017 Aug;61(7):832-840. doi: 10.1111/aas.12927. Epub 2017 Jun 20.
A CT scanner incorporated in the trauma resuscitation bay may benefit trauma patients by fastening work-up times; however, evidence in the area is still sparse. We assessed if time from admission to first CT scan was lower after incorporation of a CT scanner in the resuscitation bay.
We included trauma patients admitted in two 1-year periods, before and after a major rebuilding of the trauma room. Beforehand, one CT scanner was located in an adjacent room. After the rebuilding, two mobile CT scanners were placed in the resuscitation bays, where a moving gantry was combined with a trauma resuscitation table. Subgroup analyses were performed on severely injured and patients with traumatic brain injury.
We included 784 patients before and 742 patients after the reconstruction. Case-mix differed between study periods as there was a higher proportion of severe injuries, traumatic brain injury and penetrating trauma in the after period. We found a minor increase in time to CT in the after period (20 vs. 21 min, P = 0.008). In a multivariate regression analysis adjusted for differences in case-mix and with time to CT as outcome, period was an insignificant explanatory variable [β (before vs. after): 0.96 min 95% CI: 0.9-1.02, P = 0.3]. In both subgroups, we found no significant difference in time to CT.
We found no reduction in time to CT scan, when comparing a period with mobile CT scanners incorporated in the resuscitation bay to an earlier period with a CT scanner next to the trauma room.
创伤复苏区配备CT扫描仪可能通过缩短检查时间使创伤患者受益;然而,该领域的证据仍然稀少。我们评估了在复苏区配备CT扫描仪后,从入院到首次CT扫描的时间是否缩短。
我们纳入了创伤室进行重大重建前后两个1年期内收治的创伤患者。此前,一台CT扫描仪位于相邻房间。重建后,两台移动CT扫描仪被放置在复苏区,其中移动机架与创伤复苏台相结合。对重伤患者和创伤性脑损伤患者进行了亚组分析。
我们纳入了重建前的784例患者和重建后的742例患者。研究期间的病例组合有所不同,因为后期重伤、创伤性脑损伤和穿透伤的比例更高。我们发现后期至CT的时间略有增加(20分钟对21分钟,P = 0.008)。在一项针对病例组合差异进行调整并以至CT时间为结果的多变量回归分析中,时期是一个无显著意义的解释变量[β(前期对后期):0.96分钟,95%CI:0.9 - 1.02,P = 0.3]。在两个亚组中,我们均未发现至CT时间存在显著差异。
与创伤室旁配备CT扫描仪的早期相比,我们发现在复苏区配备移动CT扫描仪的时期,至CT扫描的时间并未缩短。