TY - JOUR
T1 - Systematic review and meta-analysis of routine total body CT compared with selective CT in trauma patients
AU - Healy, Donagh A.
AU - Hegarty, Aidan
AU - Feeley, Iain
AU - Clarke-Moloney, Mary
AU - Grace, Pierce A.
AU - Walsh, Stewart R.
PY - 2014/2
Y1 - 2014/2
N2 - Background: Full-body CT scanning is increasingly being used in the initial evaluation of severely injured patients. We sought to analyse the literature to determine the benefits of full-body scanning in terms of mortality and length of time spent in the emergency department (ED). Methods: A systematic search of the Pubmed and Cochrane Library databases was performed. Eligible studies compared trauma patients managed with selective CT scanning with patients who underwent immediate full-body scanning. Using random effects modelling, the pooled OR was used to calculate the effect of routine full-body CT on mortality while the pooled weighted mean difference was used to analyse the difference in ED time. Results: Five studies (8180 patients) provided mortality data while four studies (6073 patients) provided data on ED time. All were non-randomised cohort studies and were prone to several sources of bias. There was no mortality difference between groups (pooled OR=0.68; 95% CI 0.43 to 1.09, p=0.11). There was a significant reduction in the time spent in the ED when patients underwent full-body CT (pooled effect size of weighted mean difference= -32.39 min; 95% CI -51.78 to -13.00; p=0.001). Conclusions: We eagerly await the results of randomised controlled trials. Firm clinical outcome data are expected to emerge in the near future, though data on cost and radiation exposure will be needed before definitive conclusions can be made.
AB - Background: Full-body CT scanning is increasingly being used in the initial evaluation of severely injured patients. We sought to analyse the literature to determine the benefits of full-body scanning in terms of mortality and length of time spent in the emergency department (ED). Methods: A systematic search of the Pubmed and Cochrane Library databases was performed. Eligible studies compared trauma patients managed with selective CT scanning with patients who underwent immediate full-body scanning. Using random effects modelling, the pooled OR was used to calculate the effect of routine full-body CT on mortality while the pooled weighted mean difference was used to analyse the difference in ED time. Results: Five studies (8180 patients) provided mortality data while four studies (6073 patients) provided data on ED time. All were non-randomised cohort studies and were prone to several sources of bias. There was no mortality difference between groups (pooled OR=0.68; 95% CI 0.43 to 1.09, p=0.11). There was a significant reduction in the time spent in the ED when patients underwent full-body CT (pooled effect size of weighted mean difference= -32.39 min; 95% CI -51.78 to -13.00; p=0.001). Conclusions: We eagerly await the results of randomised controlled trials. Firm clinical outcome data are expected to emerge in the near future, though data on cost and radiation exposure will be needed before definitive conclusions can be made.
UR - http://www.scopus.com/inward/record.url?scp=84892788312&partnerID=8YFLogxK
U2 - 10.1136/emermed-2012-201892
DO - 10.1136/emermed-2012-201892
M3 - Review article
C2 - 23314211
AN - SCOPUS:84892788312
SN - 1472-0205
VL - 31
SP - 101
EP - 108
JO - Emergency Medicine Journal
JF - Emergency Medicine Journal
IS - 2
ER -