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 Brasel, Martin Schreiber

Research output: Contribution to journalArticle

8 Citations (Scopus)

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

Pelvis
Abdomen
Ultrasonography
Tomography
Wounds and Injuries
Hypotension
Emergencies
Mortality
Dialysis
Odds Ratio
Confidence Intervals

Keywords

  • Computed tomography scan
  • FAST examination
  • Trauma

ASJC Scopus subject areas

  • Surgery

Cite this

An abdominal computed tomography may be safe in selected hypotensive trauma patients with positive Focused Assessment with Sonography in Trauma examination. / Cook, MacKenzie R.; Holcomb, John B.; Rahbar, Mohammad H.; Fox, Erin E.; Alarcon, Louis H.; Bulger, Eileen M.; Brasel, Karen; Schreiber, Martin.

In: American Journal of Surgery, Vol. 209, No. 5, 01.05.2015, p. 834-840.

Research output: Contribution to journalArticle

Cook, MacKenzie R. ; Holcomb, John B. ; Rahbar, Mohammad H. ; Fox, Erin E. ; Alarcon, Louis H. ; Bulger, Eileen M. ; Brasel, Karen ; Schreiber, Martin. / An abdominal computed tomography may be safe in selected hypotensive trauma patients with positive Focused Assessment with Sonography in Trauma examination. In: American Journal of Surgery. 2015 ; Vol. 209, No. 5. pp. 834-840.
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AB - 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.

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