Kumada Keisuke, Murakami Nobuo, Okada Hideshi, Toyoda Izumi, Ogura Shinji, Asano Takahiko
Patient Safety Division Gifu University Hospital Gifu Japan.
Department of Emergency & Disaster Medicine Gifu University School of Medicine Gifu Japan.
Acute Med Surg. 2019 Mar 27;6(3):274-278. doi: 10.1002/ams2.410. eCollection 2019 Jul.
Whole-body computed tomography (CT) for trauma occasionally reveals significant incidental findings not related to trauma, which require an adequate response. In this study, we examined the current state of incidental findings in trauma patients on whole-body CT and the effects of the feedback system.
The subject sample included trauma patients who underwent whole-body CT while being examined for trauma during the 2-year period, with the interpretation of the CT reported by a radiologist. The frequency and recognition of incidental findings and the involved body region were investigated. The state of incidental findings before and after implementation of a radiography report feedback system was also examined.
During the study period, whole-body CT revealed incidental findings in 79 of 199 trauma patients (40.1%). The mean age of the 79 patients with incidental findings was 62.8 ± 19.5 years, and the mean injury severity score was 16.6 ± 10.0. No difference was observed in the severity of trauma, age, or length of hospital stay. The incidental findings were related to the liver/gallbladder in 22 patients, kidneys in 17, lungs in 14, and the intracranial area in 13. The recognition rate of incidental findings after the implementation of the feedback system increased from 23.3% to 32.6%.
Considering that not all incidental findings are accurately recognized, a proper feedback system is required. A feedback system is beneficial and a need to ensure improvement in the recognition of incidental findings.
创伤患者的全身计算机断层扫描(CT)偶尔会发现与创伤无关的重大偶然发现,这需要做出适当应对。在本研究中,我们检查了创伤患者全身CT偶然发现的现状以及反馈系统的效果。
研究样本包括在两年期间因创伤接受检查时进行全身CT的创伤患者,CT由放射科医生解读。调查偶然发现的频率、识别情况以及涉及的身体部位。还检查了实施影像学报告反馈系统前后偶然发现的情况。
在研究期间,199例创伤患者中有79例(40.1%)通过全身CT发现了偶然发现。79例有偶然发现的患者的平均年龄为62.8±19.5岁,平均损伤严重程度评分为16.6±10.0。在创伤严重程度、年龄或住院时间方面未观察到差异。偶然发现涉及肝脏/胆囊的有22例患者,肾脏17例,肺部14例,颅内区域13例。实施反馈系统后偶然发现的识别率从23.3%提高到了32.6%。
鉴于并非所有偶然发现都能被准确识别,需要一个适当的反馈系统。反馈系统是有益的,并且有必要确保偶然发现的识别得到改善。