In a recent paper published in the European Journal of Radiology, University of South Australia medical imaging student Elio Arruzza and his co-authors found that whole body CT (WBCT) scans drastically cut the time spent in emergency departments as the procedure is far quicker than the traditional method of x-rays, ultrasound and selective CT scans of individual body regions.
WBCT is broadly defined as a CT scan of the head, cervical spine, chest, abdomen and pelvis. The superior diagnostic accuracy of WBCT also makes it less likely that injuries are missed or even misdiagnosed, which happens with conventional imaging in up to 39 percent of cases, Arruzza and his co-authors found. However, WBCT imparts more radiation dose than other imaging procedures or non-WBCT, which clinicians, patients and families need to consider when weighing up the options.
In a meta-analysis of radiological procedures, Arruzza reviewed 14 studies comparing WBCT outcomes with conventional radiological procedures, or non-WBCT. While mortality rates, intensive care unit and hospital length stays were similar, time spent in emergency departments was significantly reduced.
“Our findings show that patients presenting with traumatic injuries can be diagnosed a lot faster with WBCT and therefore treated more quickly. This could in turn potentially reduce the impact of emergency department overcrowding, or ramping, which is a major problem in Adelaide and nationally,” Arruzza says. “Much like the saying ‘time is brain’ in terms of stroke patients, ‘time is life’ for trauma patients. With expected improvements in the technology, we not only expect faster times but lower radiation doses as well.”
While the evidence suggests there is little difference in mortality rates between WBCT and non-WBCT, Arruzza says this is due to WBCT being reserved for critically ill patients.
“Less severely injured patients are still being scanned via the traditional x-ray, ultrasound and selective CT procedures so it is difficult to compare what their progress would be like if they received a full body scan,” he says.
More than five million people die from traumatic injuries each year, accounting for nine percent of global mortality and the leading cause of death among people under the age of 45. About 60 percent of trauma-related deaths occur within an hour after injury, compared to 30 percent within 24 hours and the remainder over a longer period.
“Systematic review and meta-analysis of whole-body computed tomography compared to conventional radiological procedures of trauma patients” is authored by Elio Arruzza, Shayne Chau and Dr Janine Dizon.
