Whole-Body CT in Haemodynamically Unstable Severely Injured Patients – A Retrospective, Multicentre Study
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{"title"=>"Whole-Body CT in Haemodynamically Unstable Severely Injured Patients - A Retrospective, Multicentre Study", "type"=>"journal", "authors"=>[{"first_name"=>"Stefan", "last_name"=>"Huber-Wagner", "scopus_author_id"=>"8544954400"}, {"first_name"=>"Peter", "last_name"=>"Biberthaler", "scopus_author_id"=>"7003955692"}, {"first_name"=>"Sandra", "last_name"=>"Häberle", "scopus_author_id"=>"55623958000"}, {"first_name"=>"Matthias", "last_name"=>"Wierer", "scopus_author_id"=>"24559733800"}, {"first_name"=>"Martin", "last_name"=>"Dobritz", "scopus_author_id"=>"6603689346"}, {"first_name"=>"Ernst", "last_name"=>"Rummeny", "scopus_author_id"=>"16690373900"}, {"first_name"=>"Martijn", "last_name"=>"van Griensven", "scopus_author_id"=>"7003612315"}, {"first_name"=>"Karl Georg", "last_name"=>"Kanz", "scopus_author_id"=>"7003802411"}, {"first_name"=>"Rolf", "last_name"=>"Lefering", "scopus_author_id"=>"7005971535"}], "year"=>2013, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"84880826630", "doi"=>"10.1371/journal.pone.0068880", "pui"=>"369437993", "pmid"=>"23894365", "scopus"=>"2-s2.0-84880826630", "issn"=>"19326203", "isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)"}, "id"=>"705f8e41-fc77-374e-a0f0-1bd818b39b53", "abstract"=>"BACKGROUND: The current common and dogmatic opinion is that whole-body computed tomography (WBCT) should not be performed in major trauma patients in shock. We aimed to assess whether WBCT during trauma-room treatment has any effect on the mortality of severely injured patients in shock.\\n\\nMETHODS: In a retrospective multicenter cohort study involving 16719 adult blunt major trauma patients we compared the survival of patients who were in moderate, severe or no shock (systolic blood pressure 90-110,<90 or >110 mmHg) at hospital admission and who received WBCT during resuscitation to those who did not. Using data derived from the 2002-2009 version of TraumaRegister®, we determined the observed and predicted mortality and calculated the standardized mortality ratio (SMR) as well as logistic regressions.\\n\\nFINDINGS: 9233 (55.2%) of the 16719 patients received WBCT. The mean injury severity score was 28.8±12.1. The overall mortality rate was 17.4% (SMR  = 0.85, 95%CI 0.81-0.89) for patients with WBCT and 21.4% (SMR = 0.98, 95%CI 0.94-1.02) for those without WBCT (p<0.001). 4280 (25.6%) patients were in moderate shock and 1821 (10.9%) in severe shock. The mortality rate for patients in moderate shock with WBCT was 18.1% (SMR 0.85, CI95% 0.78-0.93) compared to 22.6% (SMR 1.03, CI95% 0.94-1.12) to those without WBCT (p<0.001, p = 0.002 for the SMRs). The mortality rate for patients in severe shock with WBCT was 42.1% (SMR 0.99, CI95% 0.92-1.06) compared to 54.9% (SMR 1.10, CI95% 1.02-1.16) to those without WBCT (p<0.001, p = 0.049 for the SMRs). Adjusted logistic regression analyses showed that WBCT is an independent predictor for survival that significantly increases the chance of survival in patients in moderate shock (OR = 0.73; 95%CI 0.60-0.90, p = 0.002) as well as in severe shock (OR = 0.67; 95%CI 0.52-0.88, p = 0.004). The number needed to scan related to survival was 35 for all patients, 26 for those in moderate shock and 20 for those in severe shock.\\n\\nCONCLUSIONS: WBCT during trauma resuscitation significantly increased the survival in haemodynamically stable as well as in haemodynamically unstable major trauma patients. Thus, the application of WBCT in haemodynamically unstable severely injured patients seems to be safe, feasible and justified if performed quickly within a well-structured environment and by a well-organized trauma team.", "link"=>"http://www.mendeley.com/research/wholebody-ct-haemodynamically-unstable-severely-injured-patients-retrospective-multicentre-study", "reader_count"=>80, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>6, "Student > Doctoral Student"=>7, "Researcher"=>13, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>9, "Other"=>15, "Student > Master"=>11, "Student > Bachelor"=>7, "Lecturer"=>5, "Professor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>6, "Student > Doctoral Student"=>7, "Researcher"=>13, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>9, "Other"=>15, "Student > Master"=>11, "Student > Bachelor"=>7, "Lecturer"=>5, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>6, "Medicine and Dentistry"=>69, "Physics and Astronomy"=>3, "Computer Science"=>1, "Nursing and Health Professions"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>69}, "Physics and Astronomy"=>{"Physics and Astronomy"=>3}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Unspecified"=>{"Unspecified"=>6}}, "reader_count_by_country"=>{"New Zealand"=>1, "Austria"=>1, "Netherlands"=>1, "United States"=>2, "Andorra"=>1, "Brazil"=>2, "France"=>1, "Germany"=>2}, "group_count"=>4}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1129889"], "description"=>"<p>New ISS  =  new injury severity score; GCS  =  Glasgow coma scale; PTT  =  partial thromboplastin time; * Systolic blood pressure <90 mmHg/haemoglobin level <9 g/dL/≥10 units of packed red blood cells; The RISC score is used to calculate the probability of death of a trauma patient. It is one of the most precise prognostic major trauma score <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0068880#pone.0068880-Lefering1\" target=\"_blank\">[28]</a>, <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0068880#pone.0068880-Lefering2\" target=\"_blank\">[44]</a>, <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0068880#pone.0068880-Ruchholtz2\" target=\"_blank\">[45]</a>.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Clinical research design", "Critical care and emergency medicine", "Critical care team organization", "resuscitation", "Clinical epidemiology", "radiology", "Diagnostic radiology", "Computed tomography", "surgery", "General surgery", "Trauma surgery", "revised", "severity", "classification"], "article_id"=>754298, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Stefan Huber-Wagner", "Peter Biberthaler", "Sandra Häberle", "Matthias Wierer", "Martin Dobritz", "Ernst Rummeny", "Martijn van Griensven", "Karl-Georg Kanz", "Rolf Lefering"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0068880.t001", "stats"=>{"downloads"=>8, "page_views"=>43, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_Revised_Injury_Severity_Classification_RISC_8211_Score_/754298", "title"=>"The Revised Injury Severity Classification (RISC) – Score.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-07-24 06:36:39"}
  • {"files"=>["https://ndownloader.figshare.com/files/1129884"], "description"=>"<p>RISC  =  revised injury severity classification, CI 95%  =  confidence interval; * Inverse logistic transformation of the predicted outcome probability of RISC (mortality).</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Clinical research design", "Critical care and emergency medicine", "Critical care team organization", "resuscitation", "Clinical epidemiology", "radiology", "Diagnostic radiology", "Computed tomography", "surgery", "General surgery", "Trauma surgery", "logistic", "regression"], "article_id"=>754293, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Stefan Huber-Wagner", "Peter Biberthaler", "Sandra Häberle", "Matthias Wierer", "Martin Dobritz", "Ernst Rummeny", "Martijn van Griensven", "Karl-Georg Kanz", "Rolf Lefering"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0068880.t006", "stats"=>{"downloads"=>7, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Adjusted_logistic_regression_models_2_3_and_4_shock_subgroups_/754293", "title"=>"Adjusted logistic regression models 2,3 and 4; shock-subgroups.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-07-24 06:36:39"}
  • {"files"=>["https://ndownloader.figshare.com/files/1129888"], "description"=>"<p>Data are given as number of patients (% of total patients) or mean ± SD, unless indicated otherwise. SBP Systolic blood pressure, GCS Glasgow Coma Scale; ICU Intensive Care Unit; PRBC packed red blood cells; ISS Injury Severity Score; AIS abbreviated injury scale. p-value (comparison of WBCT vs. non-WBCT group): χ<sup>2</sup> test or Mann-Whitney-U test (two sided), *MOF, defined as organ failure of two systems of >2 SOFA score points of at least 2 days duration <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0068880#pone.0068880-Vincent1\" target=\"_blank\">[46]</a>.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Clinical research design", "Critical care and emergency medicine", "Critical care team organization", "resuscitation", "Clinical epidemiology", "radiology", "Diagnostic radiology", "Computed tomography", "surgery", "General surgery", "Trauma surgery", "injured", "patients", "compared"], "article_id"=>754297, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Stefan Huber-Wagner", "Peter Biberthaler", "Sandra Häberle", "Matthias Wierer", "Martin Dobritz", "Ernst Rummeny", "Martijn van Griensven", "Karl-Georg Kanz", "Rolf Lefering"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0068880.t003", "stats"=>{"downloads"=>3, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_severely_injured_patients_who_were_in_shock_compared_to_those_who_were_not_/754297", "title"=>"Characteristics of severely injured patients who were in shock compared to those who were not.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-07-24 06:36:39"}
  • {"files"=>["https://ndownloader.figshare.com/files/1129886"], "description"=>"<p>RISC  =  revised injury severity classification, CI 95%  =  confidence interval; * Inverse logistic transformation of the predicted outcome probability of RISC (mortality).</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Clinical research design", "Critical care and emergency medicine", "Critical care team organization", "resuscitation", "Clinical epidemiology", "radiology", "Diagnostic radiology", "Computed tomography", "surgery", "General surgery", "Trauma surgery", "logistic", "regression"], "article_id"=>754295, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Stefan Huber-Wagner", "Peter Biberthaler", "Sandra Häberle", "Matthias Wierer", "Martin Dobritz", "Ernst Rummeny", "Martijn van Griensven", "Karl-Georg Kanz", "Rolf Lefering"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0068880.t005", "stats"=>{"downloads"=>4, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Adjusted_logistic_regression_model_1_all_patients_/754295", "title"=>"Adjusted logistic regression model 1, all patients.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-07-24 06:36:39"}
  • {"files"=>["https://ndownloader.figshare.com/files/1129887"], "description"=>"<p>Data are given as number of patients (% of total patients) or mean ± SD, unless indicated otherwise. SBP Systolic blood pressure, GCS Glasgow Coma Scale; ICU Intensive Care Unit; PRBC packed red blood cells; ISS Injury Severity Score; AIS abbreviated injury scale. RISC  =  revised injury severity classification score; p-value (comparison of WBCT vs. non-WBCT group): χ<sup>2</sup> test or Mann-Whitney-U test (two sided), *MOF, defined as organ failure of two systems of >2 SOFA-score points of at least 2 days duration <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0068880#pone.0068880-Vincent1\" target=\"_blank\">[46]</a>.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Clinical research design", "Critical care and emergency medicine", "Critical care team organization", "resuscitation", "Clinical epidemiology", "radiology", "Diagnostic radiology", "Computed tomography", "surgery", "General surgery", "Trauma surgery", "injured", "patients", "ct"], "article_id"=>754296, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Stefan Huber-Wagner", "Peter Biberthaler", "Sandra Häberle", "Matthias Wierer", "Martin Dobritz", "Ernst Rummeny", "Martijn van Griensven", "Karl-Georg Kanz", "Rolf Lefering"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0068880.t002", "stats"=>{"downloads"=>3, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_severely_injured_patients_with_information_about_CT_during_trauma_room_treatment_/754296", "title"=>"Characteristics of severely injured patients with information about CT during trauma room treatment.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-07-24 06:36:39"}
  • {"files"=>["https://ndownloader.figshare.com/files/1129885"], "description"=>"<p>Data are given as number of patients or % (mortality rate). SMR  =  standardized mortality ratio, BP  =  blood pressure on admission; RISC  =  revised injury severity classification score (mortality prognosis); p-value: t-test (two sided) comparing the two SMRs of each subgroup; NNT  =  number needed to treat or scan.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Clinical research design", "Critical care and emergency medicine", "Critical care team organization", "resuscitation", "Clinical epidemiology", "radiology", "Diagnostic radiology", "Computed tomography", "surgery", "General surgery", "Trauma surgery", "ratios"], "article_id"=>754294, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Stefan Huber-Wagner", "Peter Biberthaler", "Sandra Häberle", "Matthias Wierer", "Martin Dobritz", "Ernst Rummeny", "Martijn van Griensven", "Karl-Georg Kanz", "Rolf Lefering"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0068880.t004", "stats"=>{"downloads"=>4, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Standardized_mortality_ratios_8211_SMRs_/754294", "title"=>"Standardized mortality ratios – SMRs.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-07-24 06:36:39"}
  • {"files"=>["https://ndownloader.figshare.com/files/1129882"], "description"=>"<p>The data points are drawn at the mean blood pressure value of the each group. The values of the SMRs are given in <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0068880#pone-0068880-t004\" target=\"_blank\">table 4</a>. The whiskers show the standard error. SMR  =  standardized mortality ratio.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Clinical research design", "Critical care and emergency medicine", "Critical care team organization", "resuscitation", "Clinical epidemiology", "radiology", "Diagnostic radiology", "Computed tomography", "surgery", "General surgery", "Trauma surgery", "subgroup", "groups"], "article_id"=>754291, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Stefan Huber-Wagner", "Peter Biberthaler", "Sandra Häberle", "Matthias Wierer", "Martin Dobritz", "Ernst Rummeny", "Martijn van Griensven", "Karl-Georg Kanz", "Rolf Lefering"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0068880.g002", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_SMR_subgroup_analysis_of_the_different_shock_groups_at_hospital_admission_lt_90_90_110_and_gt_110_mmHg_/754291", "title"=>"SMR subgroup analysis of the different shock groups at hospital admission (<90, 90-110, and >110 mmHg).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-07-24 06:36:39"}
  • {"files"=>["https://ndownloader.figshare.com/files/1129881"], "description"=>"<p>ISS  =  Injury severity score, WBCT  =  whole-body CT, BP  =  blood pressure on hospital admission; RISC  =  revised injury severity classification score; transfer in patients: no data of resuscitation in primary hospital; transfer out patients (<48 h): no outcome data of final hospital; missing and excluded groups: overlapping numbers possible; * moderate shock on hospital admission: BP  = 90–110 mmHg; * severe shock on hospital admission: BP <90 mmHg.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Clinical research design", "Critical care and emergency medicine", "Critical care team organization", "resuscitation", "Clinical epidemiology", "radiology", "Diagnostic radiology", "Computed tomography", "surgery", "General surgery", "Trauma surgery", "diagram"], "article_id"=>754290, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Stefan Huber-Wagner", "Peter Biberthaler", "Sandra Häberle", "Matthias Wierer", "Martin Dobritz", "Ernst Rummeny", "Martijn van Griensven", "Karl-Georg Kanz", "Rolf Lefering"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0068880.g001", "stats"=>{"downloads"=>8, "page_views"=>47, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_STROBE_diagram_of_study_population_/754290", "title"=>"STROBE diagram of study population.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-07-24 06:36:39"}

PMC Usage Stats | Further Information

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Relative Metric

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