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Updated: Jul 1, 2025
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Coronary artery calcification detected by initial polytrauma CT in severely injured patients: retrospective
Hans-Jonas Meyer1, Tihomir Dermendzhiev1, Michael Hetz2
1Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Liebigstr.20, 04103, Leipzig, Germany.
Insights
Coronary artery calcifications detected by computed tomography (CT) predict mortality in severely injured trauma patients. This finding also influences intensive care unit length of stay for survivors.
Area of Science:
- Radiology
- Trauma Surgery
- Cardiology
Background:
- Coronary artery calcifications (CAC) on computed tomography (CT) have prognostic value for cardiovascular disease.
- The prognostic significance of CAC in severely injured trauma patients is not well-established.
Purpose of the Study:
- To investigate the prognostic relevance of CT-detected CAC using the Weston score in severely injured trauma patients requiring tracheal intubation.
Main Methods:
- A retrospective analysis of 458 severely injured trauma patients who underwent tracheal intubation and initial CT scan.
- The Weston score was used to quantify CAC, and its association with 24-hour and 30-day mortality, ICU length of stay (LOS), and mechanical ventilation duration was assessed.
Main Results:
- CAC was present in 46.7% of patients.
- The Weston score independently predicted 24-hour (HR 1.19) and 30-day mortality (HR 1.09).
- In survivors, the Weston score was associated with longer ICU LOS (beta 0.89) but not mechanical ventilation duration.
Conclusions:
- CT-detected CAC, quantified by the Weston score, is a significant independent predictor of short-term mortality in severely injured trauma patients.
- CAC also impacts ICU length of stay in surviving trauma patients.
Objectives:
Coronary artery calcifications detected by computed tomography (CT) provide prognostic relevance for vascular disorders and coronary heart disease, whereas their prognostic relevance in severely injured trauma patients remains unclear.
Material And Methods:
All consecutive trauma patients requiring emergency tracheal intubation before initial CT at a level-1 trauma center and admission to the intensive care unit (ICU) over a 12-year period (2008-2019) were reanalyzed. The Weston score, a semiquantitative method to quantify coronary calcifications, was evaluated as a prognostic variable based upon whole-body trauma CT analysis.
Results:
Four hundred fifty-eight patients (74.6% male) with a median age of 49 years, median injury severity score of 26 points, 24-h mortality rate of 7.6%, and 30-day mortality rate of 22.1% met the inclusion criteria and were analyzed. Coronary artery calcification was present in 214 patients (46.7%). After adjustment for confounding factors, the Weston score was an independent predictor for 24-h mortality (hazard ratio, HR 1.19, 95% confidence interval, CI 1.06-1.32, p = .002) and 30-day mortality (HR 1.09, 95% CI 1.01-1.17, p = .027). In a subanalysis of 357 survivors, the Weston score was significantly associated with ICU length of stay (LOS) (beta weight 0.89, 95% CI 0.3-1.47, p = .003) but not with mechanical ventilation duration (beta weight 0.05, 95% CI -0.2-0.63, p = .304).
Conclusion:
CT-detected coronary calcification was a significant prognostic factor for 24-h- and 30-day-mortality in severely injured trauma patients requiring tracheal intubation, and influenced ICU LOS in survivors.
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