Rationalizing whole-body computed tomography in trauma: A national audit on resource utilization and strategies to minimize radiation exposure

Table 1 Demographic characteristics and classification findings, n (%)

Characteristic		Total cases (n = 1367)	Negative scan (n = 578)	Positive scan (n = 789)	P value1
Sex	Male	1074 (78.6)	427 (73.9)	647 (82.0)	< 0.0011
	Female	293 (21.4)	151 (26.1)	142 (18.0)
Age	mean ± SD	33.54 ± 16.09	32.03 ± 15.97	34.63 ± 16.09	< 0.0012
Finding classification
Major	-	-	-	530 (38.8)	-
Minor	-	-	-	259 (18.9)	-

¹χ² test.

²Mann-Whitney U test.

Table 2 Mechanism of injury and whole-body computed tomography indications - rate of positive and negative scans, n (%)

Mechanism of injury	Total cases (n = 1367)	Negative scan (n = 578)	Positive scan (n = 789)	P value1
RTA	911 (66.6)	405 (70.1)	506 (64.1)	0.376
FFH	182 (13.6)	42 (6.7)	140 (17.7)	< 0.001
Fall (fall of heavy object)	112 (8.0)	54 (9.0)	58 (7.4)	0.396
Boat accident	5 (0.4)	3 (0.5)	2 (0.3)	1.00
Buggy accident	28 (2.0)	15 (2.6)	13 (1.6)	0.563
Blast injury	2 (0.1)	0 (0.0)	2 (0.3)	1.00
Head trauma	82 (6.0)	39 (6.7)	43 (5.4)	0.264
Loss of consciousness	3 (0.2)	1 (0.2)	2 (0.3)	1.00
[Consequence of an injury]
Not mentioned	12 (0.9)	7 (1.2)	5 (0.6)	0.705
Poly trauma	4 (0.3)	2 (0.3)	2 (0.3)	1.00
Assault	24 (1.8)	9 (1.6)	15 (1.9)	0.965
Self-inflicted injury (gunshot)	2 (0.15)	1 (0.2)	1 (0.1)	1.00

¹χ² test.

FFH: Fall from height; RTA: Road traffic accident.

Table 3 Description of whole-body computed tomography scan findings and classifications, n (%)

Characteristic	WBCT finding	n = 1367
Chest	Lung contusions	162 (11.9)
	Fracture ribs/clavicle/scapula	191 (14.0)
	Pneumothorax	85 (6.2)
	Hemothorax	19 (1.4)
	Mediastinal hematoma	7 (0.5)
Abdomen	Hepatic injury	52 (3.8)
	Splenic injury	36 (2.6)
	Renal injury	12 (0.9)
	Pancreatic injury	2 (0.1)
	Hemoperitoneum	14 (1.0)
	Mesenteric injury	12 (0.9)
	Adrenal injury	5 (0.4)
	Retroperitoneal hematoma	16 (1.2)
	Intestinal injury	3 (0.2)
Pelvis	Pelvic fracture and/hematoma	112 (8.2)
	Urinary bladder rupture	2 (0.1)
	Fracture spine	242 (17.7)
Head	Brain (hemorrhage/edema/hematoma)	293 (21.4)
	Fracture skull/face	173 (12.7)
	Scalp hematoma	18 (1.3)
Others	Long bone fracture	29 (2.1)
	Muscular injury	2 (0.1)
	Vascular injury	5 (0.4)

WBCT: Whole-body computed tomography.

Table 4 Radiation characteristics and effective dose in all participated radiology departments, mean ± SD

Characteristic	Study cases (n = 1367)	Negative scan (n = 578)	Positive scan (n = 789)	P value1
CTDIvol (mGy)	84.33 ± 55.80 (8.0-596.0)	77.90 ± 49.11 (8.0-374.0)	89.01 ± 59.80 (9.0-596.0)	0.004
Scan length (cm)	44.33 ± 31.01 (5.0-153.0)	45.45 ± 32.17 (7.0-150.0)	43.53 ± 30.13 (5.0-153.0)	0.520
DLP (mGy.cm)	2299.87 ± 1115.28 (275.0-8671.0)	2148.14 ± 1102.74 (275.0-6325.0)	2410.52 ± 1112.07 (354.0-8671.0)	< 0.001
ED (mSv)	21.38 ± 10.37 (2.5-80.64)	19.98 ± 10.26 (2.56-58.82)	22.41 ± 10.35 (3.29-80.64)	< 0.001

¹Mann-Whitney U test.

CTDIvol: Computed tomography dose index-volume; DLP: Dose length product; ED: Effective dose.