Treating patients in a trauma room equipped with computed tomography and patients' mortality: a non-controlled comparison study

World J Emerg Surg. 2018 Mar 27:13:16. doi: 10.1186/s13017-018-0176-3. eCollection 2018.

Abstract

Background: To improve acute trauma care workflow, the number of trauma centers equipped with a computed tomography (CT) machine in the trauma resuscitation room has increased. The effect of the presence of a CT machine in the trauma room on a patient's outcome is still unclear. This study evaluated the association between a CT machine in the trauma room and a patient's outcome.

Methods: Our study included all trauma patients admitted to a trauma center in Yokohama, Japan, between April 2014 and March 2016. We compared 140 patients treated using a conventional resuscitation room with 106 patients treated in new trauma rooms equipped with a CT machine.

Results: For the group treated in a trauma room with a CT machine, the Injury Severity Score (13.0 vs. 9.0; p = 0.002), CT scans of the head (78.3 vs. 66.4%; p = 0.046), CT scans of the body trunk (75.5 vs. 58.6%; p = 0.007), intubation in the emergency department (48.1 vs. 30.7%; p = 0.008), and multiple trauma patients (47.2 vs. 30.0%; p = 0.008) were significantly higher and Trauma and Injury Severity Score probability of survival (96.75 vs. 97.80; p = 0.009) was significantly lower than the group treated in a conventional resuscitation room. In multivariate analysis and propensity score matched analysis, being treated in a trauma room with a CT machine was an independent predictor for fewer hospital deaths (odds ratio 0.002; 95% CI 0.00-0.75; p = 0.04, and 0.07; 0.00-0.98, respectively).

Conclusions: Equipping a trauma room with a CT machine reduced the time in decision-making for treating a trauma patient and subsequently lowered the mortality of trauma patients.

Keywords: Acute care; CT; Trauma resuscitation room.

MeSH terms

  • Adult
  • Aged
  • Decision Support Techniques
  • Emergency Service, Hospital / organization & administration
  • Emergency Service, Hospital / statistics & numerical data
  • Emergency Service, Hospital / trends
  • Female
  • Hospital Mortality*
  • Humans
  • Injury Severity Score
  • Japan
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Analysis
  • Tomography, X-Ray Computed / methods*
  • Tomography, X-Ray Computed / standards
  • Tomography, X-Ray Computed / trends
  • Trauma Centers / trends*
  • Wounds and Injuries / diagnosis*
  • Wounds and Injuries / mortality