Whole Body CT for Severe Trauma Might Not Offer Survival Advantage

Retrospective studies in European cohorts have raised the possibility that immediate, whole-body computed tomography (CT) can decrease mortality for patients with severe trauma (NEJM JW Emerg Med May 2009 and Lancet 2009 Mar 24; [e-pub]). These authors randomized 1403 Dutch and Swiss patients with severe trauma to immediate whole-body CT (non-contrast exam of head and neck, followed by split-bolus, contrast-enhanced CT of the chest, abdomen, and pelvis) or standard imaging (focused assessment with sonography in trauma [FAST] exam plus plain films of the chest and pelvis, followed by targeted CT at the discretion of the trauma team, which included trauma surgeons but no emergency physicians).

Among 1083 patients included in the primary analys…