Validity of azuma criteria for cranial imaging decision in multitrauma cases with whole body CT indication

Aim: Today, algorithms are being developed to lead to early diagnosis and treatment in order to prevent mortality and morbidity in multitrauma patients. Quickly choosing the right imaging method in patients for correct diagnosis is important in terms of providing appropriate benefits and economic expectations. In our study, the success of the Azuma criteria in the prediction of traumatic brain injury in patients with whole body computed tomography (WBCT) indication according to the rules set by the European Association of Emergency Radiology was investigated. Materials and Methods: In the retrospective study performed in a tertiary hospital, patients who were requested for WBCT within a two-year period were reached from hospital records. Cases that were referred from an external center with a preliminary radiological diagnosis, that were not suitable for WBCT imaging indications, that were not completed for any reason (technical problem, incomplete imaging), or had insufficient records were excluded from the study. Demographic data of the included cases, GCS, SBP, lesions above the clavicle, outcomes, and operations performed, if any, were recorded. If at least one of the criteria for injury above the clavicle and GCS<15 was met, AZUMA was considered positive and its validity was investigated. Results: In the study, 215 patients, 177 of whom were male, were examined. The mean age of the patients was 42.48±17.48 years. It was observed that 92 of the patients (42.79%) had trauma due to non-vehicle traffic accident (TC), and 55 (25.58%) had trauma due to non-vehicle TC. Traumatic brain injury was detected in 113 of the cases followed. 16. Patients with TBI were compared with the AZUMA criteria. While the sensitivity of the Azuma criteria for detecting TBI was 96%, the selectivity was 45%. Conclusion: The criteria suggested by Azuma et al. may provide an advantage in mortality, radiation, time and cost, with the success of cranial imaging and high TBI prediction in selected cases in multitrauma patients for whom WBCT is planned. Keywords: Traumatic Brain Injury, Emergency Service, Computed Tomography