[Direct total body CT scan in multi-trauma patients]

Area of Science:

• Emergency Medicine
• Radiology
• Trauma Surgery

Background:

• Immediate total body computed tomography (CT) is increasingly used in trauma care due to its accuracy.
• Limited evidence exists comparing immediate total body CT with conventional imaging for trauma patient outcomes.
• The REACT-2 trial aims to address this evidence gap.

Purpose of the Study:

• To determine the clinical value of immediate total body CT scanning in severely injured trauma patients.
• To compare outcomes between patients receiving immediate total body CT and those undergoing conventional imaging protocols.
• To provide evidence-based recommendations for trauma imaging strategies.

Main Methods:

• International, multicenter randomized clinical trial involving adult, severely injured trauma patients.
• Intervention group receives contrast-enhanced total body CT during primary survey.
• Control group receives conventional trauma imaging (ATLS guidelines) with selective CT scans.

Main Results:

• Primary outcome: in-hospital mortality.
• Secondary outcomes include mortality/morbidity at 1 year, work-up times, radiation exposure, quality of life, and cost-effectiveness.
• Results will elucidate the benefits and drawbacks of immediate total body CT in trauma.

Conclusions:

• The REACT-2 trial is the first multicenter randomized clinical trial to evaluate immediate total body CT in trauma.
• Findings will provide crucial evidence on the effectiveness of early, whole-body CT in the primary survey of severely injured patients.
• This research will inform clinical practice and guidelines for trauma imaging.