Whole-body CT versus selective CT in polytrauma patients : a systematic review
Bibliographic record
Abstract
Introduction : Trauma is responsible for a huge amount of mortality worldwide as well as a burden on global healthcare. Continuous development in trauma care has led to lower mortality rates and fewer complications, but the biggest challenge in current trauma care is to reduce early hospital mortality. One step toward a reduction of this fatality is using whole-body CT (WBCT) in polytrauma patients instead of the standard work-up. Standard work-up comprises of a radiograph of the chest and pelvis, Focused Assessment with Sonography in Trauma (FAST) and selective computed tomography scanning (SCT) of areas of interest. WBCT is believed to be more accurate, faster and more reliable and can thus reduce mortality and morbidity. On the other hand, WBCT exposes patients to a higher radiation dose, leads to higher costs and increases clinically irrelevant incidental findings. This systematic review aims to find consensus on the best imaging strategy. Material and methods : Multiple databases and reference lists of other systematic reviews were searched for relevant studies. Inclusion criteria were RCT and observational studies that compare WBCT and standard work-up. Outcomes assessed were mortality, morbidity, time spent in the emergency department (ED LOS), length-of-stay in hospital (hospital LOS), radiation dose and costs. The Newcastle-Ottawa Scale was used to assess the methodological quality of the selected studies. Results : A total of 25 studies were selected for this systematic review. Across all studies, data showed trends towards a decrease in mortality when WBCT is used. Multiple studies showed an increase in radiation dose when WBCT is used. There was unanimity across studies that WBCT decreases ED LOS. Hospital LOS and incidence on ventilation days and multiple organ failure (MOF) were matters of debate because of inconclusive results across studies. There was a decrease in emergency surgery and fewer missed and delayed diagnoses when WBCT is used. WBCT led to more incidental findings, with a significant proportion being clinically relevant. Data on morbidity six months after injury showed no differences. No study found a statistically significant difference in cost, although every study reported a trend towards lower costs when WBCT is used. Conclusion : WBCT is faster and has fewer missed diagnoses while showing trends towards decreasing mortality, morbidity and costs. Ionisation remains an issue, however literature shows promising results towards decreasing radiation dose to a relatively safe level compared to selective CT.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.037 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.010 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".