Tertiary survey ultrasound has no diagnostic benefit in trauma patients without abdominal injuries on standardised initial whole-body computed tomography

Abstract

Purpose: The aim of our study was to evaluate the impact of a routine tertiary survey ultrasound (US) on patient management in major trauma patients without trauma-related abdominal findings on standardised initial whole-body CT (WBCT).

Methods: In this retrospective study, all WBCT scans acquired in major trauma patients between 07/2017 and 12/2019 at a university hospital and level I trauma centre were screened. 1,024 patients were included in the final analysis. Results of tertiary survey US and patient information (demographic data, trauma mechanism, imaging findings, clinical course, medical history, and anticoagulative medication) were collected and analysed.

Results: Routine tertiary survey US revealed new abdominal findings in six out of 1,024 patients (0.6%). None of the patients had to undergo surgery or minimally invasive intervention, nor did any of the patients die as a result of abdominal injuries. Additional abdominal imaging after tertiary survey US was ordered in 39 patients (38 US, 1 US + CT). None of these patients required further treatment for abdominal injuries.

Conclusions: Routine tertiary survey US after inconspicuous standardised initial WBCT did not change clinical outcome for abdominal trauma patients.

Keywords: FAST; Follow-up sonography; Follow-up ultrasound; Major trauma; Tertiary survey ultrasound; Whole-body CT.