Evaluation of incidental findings of whole body computed tomography in multiple trauma patients in emergency department

Abstract

Aim: The aim of this study was to investigate the frequency of incidental findings and the clinically significant ones in whole-body computed tomography (WBCT) scans in multiple trauma patients in the emergency department (ED). Material and Methods: This study was designed as a single-centered retrospective cohort in a tertiary emergency room. Multiple trauma patients who were screened with WBCT in the ED in 2017 were analyzed. Incidental findings (IF) were categorized into 3 groups as group 1 (emergency treatment / need further examination), group 2 (need examination depending on the symptoms of patients) and group 3 (minor findings with no need for further examination). Results: WBCT screening was performed in 206 of 3746 patients (5.4%) who were admitted to the trauma unit in ED due to multiple traumas. A total of 360 IFs were found in 138 (67%) of 206 patients. Of the patients, 13.3% were classified as group 1, 30.9% as group 2, 55.8% as group 3 and IF was detected, respectively (48, 111, 201). Cardiomegaly was the most common finding in group 1 (n = 11). In group 2, hepatomegaly (n = 18) and atherosclerosis (n = 13) were the most common ones observed. Brain calcifications (n = 42) and renal cysts (n = 17) were the most common findings in Group 3. The age distribution of patients with IF was statistically significantly higher compared to those without IF (43.54 ± 18.78, 25.16 ± 11.7, p <0.001, respectively). Conclusion: WBCT is used in the ED with an increasing frequency in multiple trauma patients and causes incidental findings to occur significantly. Some of these findings may be vital and may require further clinical evaluation and follow-up.