Increase in Use of Chest CT for Trauma

Despite a 10-fold increase in 7 years, most injuries identified after a normal x-ray were only marginally significant.

Chest computed tomography has been used with increasing frequency in the evaluation of patients with blunt and penetrating trauma, both as a single study and, more often, as part of a pan-scan. These authors used data from a single level I trauma center from 1998 through 2004 to assess trends in the use of chest CT and its incremental value over chest x-ray with normal findings.

Of 2326 chest CTs, 1873 (80.5%) were obtained following a negative chest x-ray. CT identified 102 occult pneumothoraces or hemothoraces, for which 12 (0.1%) patients underwent chest tube placement. Forty-three blunt thoracic aortic injuries were discovered, and six were occult. The annual incidence of blunt thoracic aortic injuries did not change during the 7-year st…

Reviewing Author

John A. Marx, MD, FAAEM, FACEP