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The trauma pan scan: what else do you find?

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Pan-computed tomography (CT) scans in trauma patients reveal numerous incidental findings, with only 32.6% of significant results communicated to patients, highlighting a need for improved patient follow-up and communication strategies.

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Area of Science:

  • Radiology
  • Trauma Care
  • Medical Imaging

Background:

  • Pan-computed tomography (CT) scans are increasingly used in trauma patient evaluation.
  • Incidental findings are common in these scans, necessitating clear communication protocols.
  • Effective communication of significant findings is crucial for patient outcomes.

Purpose of the Study:

  • To determine the prevalence of incidental findings in pan-CT scans of trauma patients.
  • To assess the communication rate of significant incidental findings to patients.
  • To identify areas for improvement in reporting and patient follow-up.

Main Methods:

  • Retrospective chart review of 555 adult trauma patients who underwent pan-CT scans (head, neck, chest, abdomen/pelvis).
  • Analysis of non-traumatic incidental findings and their prevalence.
  • Examination of discharge summaries for documentation of communication of significant findings.

Main Results:

  • 1706 incidental findings were identified across 555 pan-CT scans (3.1 per patient).
  • The abdomen/pelvis showed the highest concentration of findings; simple renal cysts were most common (7.7%).
  • 282 significant findings (e.g., lung nodules) were noted, but only 32.6% were documented as reported to patients.

Conclusions:

  • Pan-CT scans yield numerous incidental findings in trauma patients, many benign.
  • A significant gap exists in communicating potentially serious incidental findings to patients.
  • Improving communication of significant incidental findings is essential for patient benefit and timely follow-up.