Whole-body CT doesn't improve survival for children with blunt trauma
Whole-body computed tomography (WBCT) doesn't impact a child's chances of survival compared to a selective CT approach, according to study findings published online April 9 by the Journal of the American Medical Association.
From 2010 through 2014, from the National Trauma Bank, researchers collected data from 42,913 children between the ages of 6 months and 14 years with blunt trauma who received an emergent CT scan within two hours after arriving at the emergency department. James A. Meltzer, MD, MS, from Albert Einstein College of Medicine in New York, led the research.
Meltzer and colleagues found that 20.4 percent of the children (average age of 9 and 64.9 percent boys) received a WBCT. Additionally, 0.9 percent of total participants died within seven days of arriving to the ED. Mortality was high for children who were hypotensive, remained in the intensive care unit or obtained a responsiveness score of nine or less on the Glasgow Coma Scale, the researchers wrote.
Overall, children who received WBCT had the same mortality rate compared with those who underwent a selective CT approach, as the researchers found with their developed propensity model. The model adjusted for any bias due to age, sex, race, injury type, responsiveness, trauma center status, hospital region and additional factors.
"The results of this study raise questions about the routine, indiscriminate use of emergent WBCT for children with blunt trauma; a more selective approach to computed tomography imaging for children with blunt trauma is warranted," the researchers concluded.
Study results also demonstrated how emergency and trauma specialists care for children, according to the researchers, and what areas in pediatric imaging lack improvement.
"The lack of improvement in mortality that we observed may suggest that any additional injuries that might have been detected by WBCT were either not life-threatening or did not offset the potential risk of an injured patient receiving a prolonged CT scan," the researchers wrote. "While we recognize that the importance of identifying all non-life-threatening injuries and incidental findings will continue to be a matter of debate, there is a shift in recent times for researchers to focus on identifying only injuries that are believed to be clinically important."
A recent graduate from Dominican University (IL) with a bachelor’s in journalism, Melissa joined TriMed’s Chicago team in 2017 covering all aspects of health imaging. She’s a fan of singing and playing guitar, elephants, a good cup of tea, and her golden retriever Cooper.