Abstract
Purpose: Skeletal injuries may be missed in patients with multiple traumas during initial assessment. A whole-body bone scan (WBBS) may help detection of missed skeletal injury, but research on this is insufficient. Thus, this study aimed to investigate whether WBBS is useful for the detection of missed skeletal injury in patients with multiple traumas. Methods: This retrospective single-regional trauma center study was conducted at a tertiary referral center from January 2015 to May 2019. The rate of missed skeletal injuries detected on WBBS was evaluated, and factors that could influence the outcome were analyzed and divided into missed group and not-missed group. Results: A total of 1,658 patients with multiple traumas who underwent WBBS were reviewed. In the missed group, the percentage of Injury Severity Score (ISS) ≥ 16 was higher than that in the not-missed group (74.66% vs 45.50%). The rate of admission route through surgery and embolization was high in the missed group. Moreover, the proportion of shock patients in the missed group was higher than that in the not-missed group (19.86% vs 3.51%). In univariate analysis, ISS ≥ 16, admission route through surgery and embolization, orthopedic surgery (OS) involvement, and shock were related with the missed skeletal injury. ISS ≥ 16 was statistically significant in multivariate analysis. The nomogram constructed based on the multivariable analysis was verified by its calibration plot. Conclusion: WBBS can be a screening method to detect missed skeletal injuries in patients with multiple blunt traumas. Trial Registration: This study is registered in a Clinical Research Information System that is affiliated with the WHO International Clinical Trials Registry Platform (KCT0004371). Funding Statement: The authors stated: None. Declaration of Interests: The authors have no conflict of interest to declare. Ethics Approval Statement: This study was approved by the Institutional Review Board (CR319105).
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