Systematic review and meta-analysis of whole-body computed tomography compared to conventional radiological procedures of trauma patients.
Eur J Radiol
; 129: 109099, 2020 Aug.
Article
in English
| MEDLINE | ID: covidwho-1454122
ABSTRACT
PURPOSE:
The superior diagnostic accuracy of CT makes it an attractive tool for initial trauma imaging. This meta-analysis aimed to assess the evidence regarding the value of whole-body CT (WBCT) as part of the primary survey, in comparison to conventional radiological procedures.METHODS:
A comprehensive systematic search of the literature was conducted using keywords applied in Scopus, Cochrane and PubMed databases. Articles were eligible if they contained original data comparing the use of WBCT in the primary survey, with conventional radiological procedures. Outcomes included overall and 24â¯-h mortality, emergency department (ED) time, intensive care unit (ICU) and hospital length of stay (LOS), and multiple organ dysfunction syndrome/failure (MODS/MOF) incidence. Radiation dose, mechanical ventilation duration and cost were evaluated qualitatively. Analysis was performed with Covidence, MedCalc Version 19.1.3. and Meta-Essentials.RESULTS:
Fourteen studies were included. Statistical pooling demonstrated comparable rates between conventional procedures and WBCT (ORâ¯=â¯0.854, CIâ¯=â¯0.715-1.021, pâ¯=â¯0.083) in 63,529 patients across 11 studies. A significant finding favouring WBCT was discovered for ED time (SMD = -0.709, CI -1.198 to -0.220, pâ¯=â¯0.004). Patients experienced similar 24â¯-h mortality rates (pâ¯=â¯0.450), MODS/MOF incidence (pâ¯=â¯0.274), and hospital (pâ¯=â¯0.541) and ICU LOS (pâ¯=â¯0.457). WBCT is associated with increased radiation dose and mechanical ventilation duration.CONCLUSION:
This review demonstrates that WBCT markedly reduces time spent in ED. No significant differences in mortality rate are suggested. WBCT currently entails greater radiation dose and mechanical ventilation time. Further research is necessitated to address limitations of predominately retrospective observational data available.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Wounds and Injuries
/
Tomography, X-Ray Computed
/
Whole Body Imaging
Type of study:
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Qualitative research
/
Reviews
/
Systematic review/Meta Analysis
Limits:
Humans
/
Middle aged
Language:
English
Journal:
Eur J Radiol
Year:
2020
Document Type:
Article
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