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Emergency Bleeding Control Interventions After Immediate Total-Body CT Scans in Trauma Patients

REACT-2 Study Grp, Treskes, K., Saltzherr, T. P., Edwards, M. J. R., Beuker, B. J. A., Den Hartog, D., Hohmann, J., Luitse, J. S., Beenen, L. F. M., Hollmann, M. W., Dijkgraaf, M. G. W. & Goslings, J. C., Feb-2019, In : World Journal of Surgery. 43, 2, p. 490-496 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • REACT-2 Study Grp
  • Kaij Treskes
  • Teun P. Saltzherr
  • Michael J. R. Edwards
  • Benn J. A. Beuker
  • D. Den Hartog
  • Joachim Hohmann
  • Jan S. Luitse
  • Ludo F. M. Beenen
  • Markus W. Hollmann
  • Marcel G. W. Dijkgraaf
  • J. Carel Goslings

BackgroundImmediate total-body CT (iTBCT) is often used for screening of potential severely injured patients. Patients requiring emergency bleeding control interventions benefit from fast and optimal trauma screening. The aim of this study was to assess whether an initial trauma assessment with iTBCT is associated with lower mortality in patients requiring emergency bleeding control interventions.MethodsIn the REACT-2 trial, patients who sustained major trauma were randomized for iTBCT or for conventional imaging and selective CT scanning (standard workup; STWU) in five trauma centers. Patients who underwent emergency bleeding control interventions following their initial trauma assessment with iTBCT were compared for mortality and clinically relevant time intervals to patients that underwent the initial trauma assessment with the STWU.ResultsIn the REACT-2 trial, 1083 patients were enrolled of which 172 (15.9%) underwent emergency bleeding control interventions following their initial trauma assessment. Within these 172 patients, 85 (49.4%) underwent iTBCT as primary diagnostic modality during the initial trauma assessment. In trauma patients requiring emergency bleeding control interventions, in-hospital mortality was 12.9% (95% CI 7.2-21.9%) in the iTBCT group compared to 24.1% (95% CI 16.3-34.2%) in the STWU group (p=0.059). Time to bleeding control intervention was not reduced; 82min (IQR 5-121) versus 98min (IQR 62-147), p=0.108.ConclusionsReduction in mortality in trauma patients requiring emergency bleeding control interventions by iTBCT could not be demonstrated in this study. However, a potentially clinically relevant absolute risk reduction of 11.2% (95% CI -0.3 to 22.7%) in comparison with STWU was observed.Trial registrationClinicalTrials.gov: NCT01523626.

Original languageEnglish
Pages (from-to)490-496
Number of pages7
JournalWorld Journal of Surgery
Volume43
Issue number2
Publication statusPublished - Feb-2019

    Keywords

  • COMPUTED-TOMOGRAPHY, BLUNT

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