Predictors of the selective use of chestcomputed tomography in road traffic accident patients with none clinically evident chest trauma

ABSTRACT

The purpose of this study is to identify predictors that select road traffic accident patients with no clinical evidence of chest trauma who will need to do Chest CT. This prospective study was conducted to include one hundred patients with Road traffic accident injuries admitted to the Emergency Department of Alexandria main university hospital. Primary survey and secondary survey, radiological investigations including CT chest and other radiological investigations were done to all patients. This also includes laboratory tests to asses’ arterial blood gases and hemoglobin level. In our study 74% of patients had positive CT chest finding despite normal initial chest examination and six predictors were identified to have a significant relation to CT chest positivity and they are age≥55yrs old (with p value =0.024), abnormal arterial blood gases result (p =0.003), hemoglobin <9gm/dl (p =0.010), disturbed level of consciousness (p=0.002), presence of fracture dorsal spine (p = 0.019) and presence of abdominal collection associated with pelvic fracture with a p value = 0.033).

Key words: blunt chest trauma, chest imaging, chest computed tomography

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