Abdominal computed tomography scan as a screening tool in blunt trauma. Surgery 1996 Oct;120(4):780-3; discussion 783-4
Date
10/01/1996Pubmed ID
8862392DOI
10.1016/s0039-6060(96)80031-6Scopus ID
2-s2.0-0029786692 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
BACKGROUND: One of the most difficult problems in blunt trauma is evaluation for potential intraabdominal injury. Admission for serial abdominal exams remains the standard of care after intraabdominal injury has been initially excluded. We hypothesized a normal abdominal computed tomography (CT) scan in a subgroup of minimally injured patients would obviate admission for serial abdominal examinations, allowing safe discharge from the emergency department (ED).
METHODS: We reviewed our blunt trauma experience with patients admitted solely for serial abdominal examinations after a normal CT. Patients were identified from the trauma registry at a Level 1 trauma center from July 1991 through June 1995. Patients with abnormal CTs, extra-abdominal injuries necessitating admission, hemodynamic abnormalities, a Glasgow Coma Scale less than 13, or injury severity scores (ISSs) greater than 15 were excluded. Records of 238 patients remained; we reviewed them to determine the presence of missed abdominal injury.
RESULTS: None of the 238 patients had a missed abdominal injury. Average ISS of these patients was 3.2 (range, 0 to 10). Discharging these patients from the ED would result in a yearly cost savings of $32,874 to our medical system.
CONCLUSIONS: Abdominal CT scan is a safe and cost-effective screening tool in patients with blunt trauma. A normal CT scan in minimally injured patients allows safe discharge from the ED.
Author List
Brasel KJ, Borgstrom DC, Kolewe KA, Weigelt JAMESH terms used to index this publication - Major topics in bold
Abdominal InjuriesCosts and Cost Analysis
Follow-Up Studies
Humans
Patient Admission
Retrospective Studies
Tomography, X-Ray Computed
Wounds, Nonpenetrating
