Abstract

BACKGROUND
Computed tomography (CT) of injured patients in the radiology department requires potentially dangerous and time-consuming patient transports and transfers. It was hypothesized that CT in the trauma room would improve patient outcome and workflow.
METHODS
A randomized trial compared the effect of locating a CT scanner in the trauma room versus the radiology department in two Dutch trauma hospitals. Injured patients aged at least 16 years were assigned randomly to one of these hospitals at the time of transport. The primary outcome measure was the number of non-institutionalized days within the first year after randomization. Subgroup analyses were performed in patients with multiple trauma or severe traumatic brain injury (TBI).
RESULTS
Some 1124 patients were included, of whom 1045 were available for analysis. The median number of non-institutionalized days was 360 days in the intervention group versus 362 days for the control group (P = 0.068). The time from arrival to the first CT imaging was 13 min shorter in the intervention group (36 versus 49 min; P < 0.001). Patient transfers and transports were reduced by more than half in the intervention group. For both multiple trauma (265 patients) and TBI (121) subgroups, differences in mortality and out-of-hospital days favoured the intervention group, but were not statistically significant.
CONCLUSION
A CT scanner located in the trauma room reduces the time to acquire CT images and improves workflow, but does not lead to substantial improvements in clinical outcomes in a general trauma population. Observed beneficial effects on outcomes in patients with multiple trauma or severe TBI were not statistically significant. Registration number: ISRCTN55332315 (http://www.controlled-trials.com).

Links

Publisher Full Text

Authors

Saltzherr TP, Bakker FC, Beenen LF, Dijkgraaf MG, Reitsma JB, Goslings JC, REACT Study Group

Institution

Trauma Unit, Department of Surgery, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, The Netherlands.

Source

The British journal of surgery 99 Suppl 1: 2012 Jan pg 105-13

MeSH

Adult
Female
Humans
Injury Severity Score
Intensive Care
Length of Stay
Male
Middle Aged
Quality of Life
Radiology Department, Hospital
Time Factors
Tomography, X-Ray Computed
Trauma Centers
Treatment Outcome
Wounds and Injuries

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22441863