04:21 PM Abstract No. 247 Factors that may affect extravasation seen on institutional trauma CT evaluation of patients with traumatic injuries

Abstract

To determine if systolic blood pressure and hemoglobin concentration impact detection of acute traumatic hemorrhage/extravasation on our institutional trauma computed tomography (tCT) protocol. A retrospective chart review of patients who underwent selective angiography after tCT (late arterial/early portal venous phase) and demonstrated traumatic injury between June 2015 and July 2018 was performed. A positive tCT was defined as extravasation noted in association with traumatic injury. Corresponding angiograms were considered positive if extravasation was noted on arteriograms. Demographic data, type injury, coexisting traumatic injuries, hemodynamic parameters, relevant lab values (i.e hemoglobin (Hgb) concentration, platelets, INR), time of tCT, time of angiography and post-angiography outcomes were recorded. A Wilcoxon-Mann Whitney analysis was performed to compare groups. 118 patients received a tCT for evaluation after presenting with trauma. Of these, 101 patients (70 males (69%) and 31 females (31%), (mean age 44 ± 22 yrs)) had systolic blood pressures documented at the time of the tCt, and 109 patients (81 males (74%) and 28 females (27%), (mean age 44 ± 21 yrs)) had hemoglobin levels documented at the time of the tCt. The cohort was divided into 2 groups depending on findings on tCT: Group A demonstrated active arterial extravasation on tCT and Group B did not. The average systolic blood pressure for Group A (122.16 ± 26.86 mm Hg; n=67) was greater than Group B (110.0 ± 31.6 mm Hg; n = 34), and this difference was statistically significant (p < 0.05). The average hemoglobin level for Group A (12.8 ± 2.0 mg/dl; n=71) was greater than Group B (11.7 ± 2.0 mg/dl; n = 38), and this difference was also statistically significant (p < 0.01). Systolic blood pressure and hemoglobin levels may impact active extravasation seen on late arterial/early portal venous phase CT imaging in patients presenting for evaluation of trauma. Resuscitation prior to imaging may result in improved sensitivity of the examination.