Does the presence of ultrasound really affect computed tomographic scan use? A prospective randomized trial of ultrasound in trauma

John S Rose, M. Andrew Levitt, J. Porter, A. Hutson, J. Greenholtz, F. Nobay, W. Hilty

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Objective: There is a paucity of evidence demonstrating that emergency department (ED) ultrasound changes clinical practice in trauma patients. We hypothesized that the presence of ultrasound would affect clinical decision making as evidenced through abdominal computed tomographic (CT) scan use in blunt multiple trauma patients. Methods: This study used a prospective randomized format in an urban county ED with Level II trauma center status (ED census, 72,000 patients per year). Participants were patients with multiple blunt injuries meeting trauma center triage criteria. Patients were randomized to receive either abdominal ultrasound or no ultrasound (control) during initial ED resuscitation. The primary outcome variable was use of abdominal CT scan in patients with and without ultrasound. Results: Two hundred eight patients were enrolled. The mean age was 40 ± 18 years, and 62% were men. Mechanism of injury was motor vehicle crash, 56%; automobile versus pedestrian, 18%; motorcycle crash, 16%; falls, 10%; and other, 10%. One hundred four ultrasound and 104 control patients were analyzed. There were no apparent differences between ultrasound and control groups in demographics, injury type, or Injury Severity Score. Fifty-four of 104 (52%) of the control group received abdominal CT scans versus 37 of 104 (36%) abdominal CT scans for the ultrasound group; mean difference in proportions was 15.9 (p < 0.01; 95% confidence interval, 2.6-29.1). Conclusion: In this trial, the routine use of abdominal ultrasound in the evaluation of patients with multiple blunt injuries resulted in significantly fewer abdominal CT scans being obtained. A larger trial is needed to more clearly define the clinical and financial impact of ultrasound in the management of blunt abdominal trauma.

Original languageEnglish (US)
Pages (from-to)545-549
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume51
Issue number3
StatePublished - 2001

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Wounds and Injuries
Hospital Emergency Service
Multiple Trauma
Nonpenetrating Wounds
Trauma Centers
Motorcycles
Automobiles
Control Groups
Injury Severity Score
Triage
Motor Vehicles
Censuses
Resuscitation
Demography
Confidence Intervals

ASJC Scopus subject areas

  • Surgery

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Does the presence of ultrasound really affect computed tomographic scan use? A prospective randomized trial of ultrasound in trauma. / Rose, John S; Andrew Levitt, M.; Porter, J.; Hutson, A.; Greenholtz, J.; Nobay, F.; Hilty, W.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 51, No. 3, 2001, p. 545-549.

Research output: Contribution to journalArticle

Rose, John S ; Andrew Levitt, M. ; Porter, J. ; Hutson, A. ; Greenholtz, J. ; Nobay, F. ; Hilty, W. / Does the presence of ultrasound really affect computed tomographic scan use? A prospective randomized trial of ultrasound in trauma. In: Journal of Trauma - Injury, Infection and Critical Care. 2001 ; Vol. 51, No. 3. pp. 545-549.
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