Rationality of using whole-body computed tomography in trauma patients

Abstract

Purpose: Identification of the group of patients meeting the criteria of a severe multiple trauma (polytrauma) among those admitted to the regional trauma centre and subjected to whole-body computed tomography (WBCT) due to injuries. Identification the patients for whom WBCT was the optimal choice. Material and methods: Retrospective analysis of the data of 303 patients undergoing WBCT in the period 2015-2017 with assessment of the injury severity based on the abbreviated injury scale (AIS) and injury severity score (ISS). Results: Among 303 patients undergoing WBCT due to trauma, multiple injuries with ISS > 15 were found in 74 individuals (24.4%). After excluding patients whose limb fractures increased ISS above 15, the group decreased to 63 patients (20.8%). For these patients, the WBCT may be described as the optimal imaging method at an early stage of management. Conclusions: Trauma patients are too often qualified for WBCT. Exposure to a high dose of ionising radiation associated with this modality requires critical analysis of the scope of indications and rules of conduct for trauma teams.

Analysis of the appropriateness of orthopaedic computed tomography scans as exemplified by lower extremity bones and joints

“…In Poland, the problem of unjustified referrals for CT studies was addressed by Sobiecka et al [9] as well as by Wierzchołowski et al [10] and the author of this study. The problems highlighted by the authors of papers mentioned above from various countries have been confirmed in the material analysed in Poland.…”

“…Because these examinations play an increasingly important role in the diagnostic process, they tend to be abused and used without justification or according to improper algorithms. Frequently, awareness of the consequences of exposures to ionizing radiation is lacking [1][2][3][4][8][9][10]. Avoiding such exposures would not only lead to savings due to the abandonment of unnecessary tests, but above all would be in line with the principles of radiological protection against ionizing radiation.…”