Benefit of the Vittel criteria to determine the need for whole body scanning in a severe trauma patient - 19/05/12
Abstract |
Objective |
To evaluate the use of the Vittel criteria in addition to a clinical examination to determine the need for a whole body scan (WBS) in a severe trauma patient.
Materials and methods |
Between December 2008 and November 2009, 339 severe trauma patients with at least one Vittel criterion were prospectively evaluated with a WBS. The following data were collected: the Vittel criteria present, circumstances of the accident, traumatic injury on the WBS, and irradiation. The original intent to prescribe a computed tomography (CT) scan (whole body or a targeted region), based solely on clinical signs, was specified.
Results |
Injuries were diagnosed in 55.75% of the WBS (n=189). The most common Vittel criteria were “global assessment” (n=266), “thrown, run over” (n=116), and “ejected from vehicle” (n=94). The multivariate analysis used the following as independent criteria for predicting severe traumatic injury on the WBS: Glasgow score less than 13, penetrating trauma, and colloid resuscitation greater than 11. Based solely on clinical factors, 164 patients would not have had any scan or (only) a targeted scan. In that case, 15% of the severe injuries would have been missed.
Conclusion |
Using the Vittel criteria to determine the need for a WBS in a severe trauma patient makes it possible to find serious injuries not suspected on the clinical examination, but at the cost of an increased number of normal scans.
El texto completo de este artículo está disponible en PDF.Keywords : CT scan, Multiple trauma, Emergency, Vittel criteria
Esquema
Vol 93 - N° 5
P. 371-379 - mai 2012 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.