Descriptive analysis of polytrauma CT examinations with a radiological focus on examination formalities: Data of over 2000 traumatic and non-traumatic emergency room cases

Differences in severity and complexity among polytrauma patients remain a major challenge for clinicians and radiologists worldwide. We aimed to provide a descriptive analysis of patient characteristics, trauma mechanisms, and severity in connection with the need for intensive care in polytrauma patients undergoing computed tomography (CT).

This retrospective monocentric analysis consecutively included 1993 patients (1305 males, mean age 50.67±23.40 years) with 2002 emergency room cases between 12/2015 and 06/2021. Nine patients were examined twice during the study period. CT was performed in 1897/2002 cases (94.8%). Additional magnetic resonance imaging (MRI) was obtained in 438/2002 cases. For subgroup analysis, trauma mechanisms were compared. Besides conventional trauma causes also critically ill non-trauma patients (CINT) were included. Admission time, day of the week, and month were also analyzed.

Traffic accidents constituted the largest trauma group, accounting for 847/2002 cases (42.3%). CINT with non-traumatic emergency died significantly more often (p < 0.001) than patients within the other trauma subgroups. In patients with an injury at the neck area, significantly more often an intubation was registered (p < 0.001). MRI was significantly more frequently performed in cases involving injuries to the cranium (p < 0.001), face (p < 0.001), or neck (p < 0.001). Mean time spent in the hospital was 9.96±13.49 days, and the mean time in the intensive care unit (ICU) was 6.58±9.67 days. Overall, 1171/2002 patients (58.5%) required at least one night in the ICU. A total of 233 patients died following trauma (11.6%), with a mean age of 69.92±18.67years.

Imaging strategies in polytrauma patients vary depending on the mechanism of injury and the affected body region. Especially additional MRI was more often needed when brain, face, or neck trauma was present.