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Abstract

Introduction: ATLS® does not recommend routine chest CT in stable trauma patients. Many centers use routine Chest CT. We assessed the utility of routine Chest CT. Methods: we retrospectively assessed 458 stable trauma patients at our level 1 trauma center that had both a chest x-ray[cx-ray] and Chest CT as part of initial work-up. Assessment of whether CT findings were different from cx-ray findings and if they led to a change in management was noted for each patient. The patients were separated into 2 groups; data correlated group [chest x-ray and Chest CT data] and data non-correlated group. The groups were compared with one-way analysis of variance [ANOVA]. Results: The findings between the chest CT and cx-ray correlated in 273 patients [59.5%] and non-correlated in 186 patients [40.5 %] with CT providing more data. The non-correlated group data analysis showed that there was a change in management related to CT findings in 44 patients [24 % within group and 9.6% overall]. The average revised trauma score[RTS] for the 2 groups was equivalent. The injury severity score was significantly higher for the non-correlated group as compared to the correlated group [14.2 + 0.7 versus 7.6 + 0.6 respectively, p<0.006]. The non-correlated group had a lower calculated probability of survival [92% versus 97% for the correlated group, p<0.006]. Conclusions: The routine Chest CT scan is efficacious in the management of the stable trauma patient. The non-correlation between CT and cx-ray in this population is a better marker for the identification of higher risk trauma patients than RTS.