An abdominal computed tomography may be safe in selected hypotensive trauma patients with positive Focused Assessment with Sonography in Trauma examination

MacKenzie R. Cook, John B. Holcomb, Mohammad H. Rahbar, Erin E. Fox, Louis H. Alarcon, Eileen M. Bulger, Karen J. Brasel, Martin A. Schreiber

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Background Positive Focused Assessment with Sonography in Trauma examination and hypotension often indicate urgent surgery. An abdomen/pelvis computed tomography (apCT) may allow less invasive management but the delay may be associated with adverse outcomes. Methods Patients in the Prospective Observational Multicenter Major Trauma Transfusion study with hypotension and a positive Focused Assessment with Sonography in Trauma (HF+) examination who underwent a CT (apCT+) were compared with those who did not. Results Of the 92 HF+ identified, 32 (35%) underwent apCT during initial evaluation and apCT was associated with decreased odds of an emergency operation (odds ratio.11, 95% confidence interval.001 to.116) and increased odds of angiographic intervention (odds ratio 14.3, 95% confidence interval 1.5 to 135). There was no significant difference in 30-day mortality or need for dialysis. Conclusions An apCT in HF+ patients is associated with reduced odds of emergency surgery, but not mortality. Select HF+ patients can safely undergo apCT to obtain clinically useful information.

Original languageEnglish (US)
Pages (from-to)834-840
Number of pages7
JournalAmerican journal of surgery
Volume209
Issue number5
DOIs
StatePublished - May 1 2015

    Fingerprint

Keywords

  • Computed tomography scan
  • FAST examination
  • Trauma

ASJC Scopus subject areas

  • Surgery

Cite this