Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia.
Radiology Department, University Medical City, King Saud University, Riyadh 12372, Saudi Arabia.
Medicina (Kaunas). 2024 Oct 24;60(11):1742. doi: 10.3390/medicina60111742.
The increasing use of whole-body computed tomography (WBCT) examinations, also known as panCT, in emergency departments for trauma patients has raised concerns about potential overuse and the associated risk of unnecessary radiation exposure. The purpose of this study was to examine the utilization patterns and findings of panCT scans performed over one year at a major academic hospital. : This retrospective cohort study included 531 stable trauma adult patients who underwent panCT scans in 2023. De-identified data for each patient, including the radiology report, age, gender, and total dose-length product (DLP) of the panCT scan, were retrieved and reviewed. Radiology reports were classified based on the findings as negative (no acute traumatic injuries) or positive, with positive reports further subclassified based on injury location. Injury severity scores (ISS) were also calculated based on the findings of the radiology reports. Statistical analysis was performed using the Python programming language to assess any association between the independent variables (age and gender) and the dependent variable (report findings: negative or positive). About 57% (n = 303) of the panCT scans included in the analysis were negative. The chi-squared test and logistic regression revealed a significant association between age and report finding (negative or positive), while no association with gender was found. One-third of positive cases (n = 72) had injuries only in the head and neck (H&N) region, and another one-third (n = 72) had injuries only in chest-abdomen-pelvis (CAP) region. Most cases (n = 373; 70%) had an ISS between 1 and 8, which is a mild score. This study showed a high rate of negative panCT scans, suggesting potential overuse of panCT. The study results highlight the need for more selective CT imaging approaches in emergency settings. Following evidence-based guidelines and decision-support tools could promote appropriate utilization of panCT scans, reducing unnecessary radiation exposure while ensuring that high-risk patients in emergency setting receive appropriate imaging.
全身计算机断层扫描（WBCT）检查，也称为 panCT，在创伤患者的急诊科中的使用越来越多，这引发了人们对过度使用的担忧以及不必要的辐射暴露的风险。本研究的目的是检查一家主要学术医院在一年中进行的 panCT 扫描的使用模式和结果。 这项回顾性队列研究纳入了 2023 年在 panCT 扫描中稳定的成年创伤患者 531 例。检索并回顾了每位患者的匿名数据，包括放射学报告、年龄、性别以及 panCT 扫描的总剂量-长度乘积（DLP）。根据放射学报告的结果将报告进行分类，分为阴性（无急性创伤性损伤）或阳性，阳性报告进一步根据损伤部位进行亚分类。还根据放射学报告的结果计算损伤严重程度评分（ISS）。使用 Python 编程语言进行统计分析，以评估独立变量（年龄和性别）与因变量（报告结果：阴性或阳性）之间的任何关联。 分析中包含的 panCT 扫描中约有 57%（n=303）为阴性。卡方检验和逻辑回归显示年龄与报告结果（阴性或阳性）之间存在显著关联，而与性别无关。三分之一的阳性病例（n=72）仅在头颈部（H&N）区域有损伤，另有三分之一（n=72）仅在胸部-腹部-骨盆（CAP）区域有损伤。大多数病例（n=373；70%）ISS 介于 1 至 8 之间，这是一个轻度评分。 本研究显示 panCT 扫描的阴性率很高，表明 panCT 可能过度使用。研究结果强调了在急诊环境中更有选择性的 CT 成像方法的必要性。遵循基于证据的指南和决策支持工具可以促进 panCT 扫描的合理使用，减少不必要的辐射暴露，同时确保急诊环境中的高危患者获得适当的影像学检查。
