The significance of clinical and instrumental methods for the diagnosis of multiple injuries in road accidents at an early hospital stage

Abstract

BACKGROUND: By reason of the high urbanization of the population the mortality rate in combined injury cases remains stably high, despite the CT-scans have appeared in the arsenal of many hospitals. There are a lot of questions: how to reduce the time of diagnosis in favor of therapeutic measures, determine the sequence of actions in different situations?

AIM: To determine the degree of informativeness of clinical and instrumental methods for diagnosing combined injuries in an accident.

MATERIALS AND METHODS: Were done a retrospective analysis of the results of treatment of 517 patients with combined trauma delivered to the emergency department of the Omsk City Clinical Hospital and the V.P. Demikhovs City Clinical Hospital of the Moscow for 2017–2019. All patients were examined by a multidisciplinary team using modern diagnostic methods including laparoscopic examination, CT according to the whole body program.

RESULTS: The results of the data analysis showed that clinical examination, radiography and ultrasound do not allow the diagnosis to be carried out in full, revealing up to 80% of all injuries.

CONCLUSION: FAST protocol has a high degree of informativeness at the early hospital stage (efficiency 83%, reliability 81%). When using modern computed tomographs with subsequent digital analysis of reconstructions, the value of performing radiographs in an urgent situation decreases. MSCT is the “gold standard” in the diagnosis of combined trauma, has a high diagnostic efficiency compared to other methods of radiation diagnostics.

Keywords

polytrauma / diagnosis of hidden injuries / CT whole body

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RIGHTS & PERMISSIONS

Yarygin N.V., Parshikov M.V., Govorova N.V., Perekhodov S.N., Govorov M.V., Chemyanov I.G., Prosvirin A.A.