The retrospective compare of whole body and selective computed tomography protocol in high energy trauma patients

There is no consensus about whole body computed tomography (WBCT) or selective computed tomography (SCT) preferance in high energy trauma patients (HETP). The aim of this study is to find the undiagnosed pathologies and the prognosis of these pathogies if SCT was conducted to HETP whom WBCT was obtained. The study also aims to find the cost, radiation dose and contrast exposure difference if SCT was preferred. We found that only 5,2% of 543 patient needed WBCT when they were re-evaluated due to their history, physical examination and E-FAST results and trauma mechanisms were not taken into consideration. Fourty two pathologies of 36 patients were skipped with SCT in 515 patients. Only 14 patients needed sipmle medical intervention requiring medical equipment (like bandages) and none of the patients were gone to surgery. We found that more pathologies are missed in patients who are older than 65 years old or under anticoagulant-antiaggregant treatment or whose GKS is lower than 14. We also noticed that radiological expenses increased 9 times if WBCT was preferred and contrast exposure increse more than 2 times. There was no diffence in skipped pathologies between the patients who meet at least one of the Vittel or REACT-2 criteria and the others. As a result we conducted that patients experienced blunt trauma with high energy only due to trauma mechanicsm, and who are fully consciousness, and have reliable history and physical examination; SCT could miss little amount of clinically unimportant pathologies and prevents unnecessary radiation or contrast exposure.