Department of General and Emergency Radiology, "A. Cardarelli" Hospital, Via A. Cardarelli 9, 80131, Naples, Italy.
Department of Emergency Surgery, "A. Cardarelli" Hospital, Via A. Cardarelli 9, 80131, Naples, Italy.
Radiol Med. 2022 Jun;127(6):637-644. doi: 10.1007/s11547-022-01495-4. Epub 2022 May 12.
Major trauma is an event causing injuries that may determine an immediate or potential risk to the patient survival. A correct management of major trauma is decisive in reducing disability, which has relevance both from the point of view of the quality of life of the single individual and from the point of view of health expenditure. The primary clinical approach to the polytraumatized patients is managed, in most cases, as outlined in the guidelines of Advanced Trauma Life Support, proposing conventional radiological investigations, such as chest and pelvis x-ray, and of FAST (focused abdominal sonography in trauma)/E-FAST (extended FAST) examinations, followed by selective targeted computed tomography (CT). This approach is questionable and is increasingly common in clinical practice the adoption of the immediate total-body CT in the diagnostic approach to the hemodynamically stable polytraumatized patient. However, the potential advantages of such conduct both in terms of clinical benefits and in terms of cost-effectiveness still need to be discussed. The objective of this review article consists of a descriptive analysis of the economic and clinical benefits of the adoption of immediate total-body CT in polytrauma patients through a literature review.
严重创伤是一种导致伤害的事件，可能会对患者的生存立即或潜在地造成威胁。正确处理严重创伤对于减少残疾至关重要，这不仅从个体生活质量的角度，而且从医疗支出的角度来看都具有重要意义。多发伤患者的主要临床处理方法，在大多数情况下，都按照高级创伤生命支持指南进行，包括常规的影像学检查，如胸部和骨盆 X 光检查，以及 FAST（创伤焦点超声检查）/E-FAST（扩展 FAST）检查，然后进行选择性的靶向计算机断层扫描（CT）。这种方法存在争议，在临床实践中越来越普遍地采用对血流动力学稳定的多发伤患者进行立即全身 CT 检查来进行诊断。然而，这种做法在临床获益和成本效益方面的潜在优势仍有待讨论。本文通过文献回顾，对多发伤患者立即行全身 CT 检查的经济和临床获益进行描述性分析。
