What Does Chest CT Add to Chest X-Ray in Blunt Trauma Victims?

Trauma patients commonly undergo computed tomographic (CT) imaging of the chest, yet evidence to guide chest imaging is conflicting, with some studies suggesting that we should scan more and others suggesting that we should scan less. Investigators from the NEXUS group conducted a secondary analysis of 5912 patients with blunt trauma who had both a chest radiograph and a chest CT scan, based on clinician discretion, at 10 Level 1 trauma center emergency departments. These patients were drawn from a larger sample of 14,533 patients who underwent either CT or radiography.

Overall, 25% of the 5912 patients had injuries discovered on chest CT but missed on chest x-ray. Of these, 14% underwent major interventions (chest tube, mechanical ventilati…