Citation

Candel BGJ, van de Pas YA, Smit-van de Wiel F. Acta Chir. Belg. 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, Informa - Taylor and Francis Group)

DOI

unavailable

PMID

unavailable

Abstract

BACKGROUND: The choice of diagnostic imaging for high-energy trauma (HET) patients is highly debated. Currently, different diagnostic imaging is used in trauma centres to identify abdominal injuries. However, it remains unclear when physicians have a suspicion for abdominal injuries, and when diagnostic imaging is performed. Over-triage may lead to unnecessary diagnostics in relatively minor injured HET-patients.

PURPOSE: We investigated which clinical factors influence the decision to perform a focused assessment with sonography in trauma (FAST) or abdominal computed tomography (CT) in HET-patients. Additionally, we investigated which clinical factors determined whether HET-patients were admitted to the hospital or discharged from the emergency department.

METHODS: Between June 2015 and January 2017, we performed a retrospective data analysis of all HET-patients in a single level II trauma centre in the Netherlands.

RESULTS: 316 HET-patients were included in this study. We found two clinical factors that proved to significantly predict whether a FAST or abdominal CT was performed: abdominal pain and the degree of concomitant injury. Furthermore, we found that the degree of concomitant injury as well as low haemoglobin levels proved to significantly predict whether a patient was admitted to the hospital for observation.

CONCLUSION: This study clarifies on which clinical factors the decision is taken to perform diagnostic imaging to identify abdominal injuries. Future prospective multicentre studies should clarify whether these clinical factors are trustworthy predictors of abdominal injuries, and whether patients can safely be discharged after trauma work-up.

Language: en

Keywords

decision-making; abdominal injuries; FAST; high-energy trauma