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Time to computed tomography: does this affect trauma patient outcomes? A retrospective analysis at an Australian major trauma centre.

Research paper by Cedric L H CLH Ng, Jason J Kim, Ben B Dobson, Don D Campbell, Martin M Wullschleger

Indexed on: 08 Nov '19Published on: 07 Nov '19Published in: ANZ Journal of Surgery



Abstract

Computed tomography (CT) is an essential diagnostic tool for severe multi-trauma patients. International guidelines recommend an optimal time of 1 h from arrival. The aim of this study was to determine the time interval from arrival at the emergency department to CT for all trauma patients and the effects on in-hospital mortality and hospital length of stay. Retrospective study of all patients who triggered a trauma call and underwent CT scanning at the Gold Coast University Hospital from January 2016 to December 2017. Exclusion criteria were scans performed at peripheral hospitals or performed more than 5 h after arrival to emergency department. One thousand six hundred and nineteen eligible trauma patients were admitted over the study period and underwent CT scanning. Median time to CT was found to be 43 min. CTs done within 1 h compared to those done after 1 h from emergency department arrival were found to have a higher mean injury severity score (11 ± 10 versus 9 ± 9, P = 0.003), a longer mean hospital length of stay (9 ± 21 versus 7 ± 13 days, P = 0.012) and no difference in mortality rates (2.2% versus 2.1%, P = 1.000). Age, injury severity score and intubation status were identified as independent predictors for longer hospital length of stay and higher mortality while time to CT did not. Injury severity score was shown to be an independent predictor of time to CT. Our time to CT scanning is well within the timeframe recommended by international guidelines. Early CT scanning may also improve outcomes in severely injured trauma patients. © 2019 Royal Australasian College of Surgeons.