CT imaging in motorcycle collision victims: routine or selective?

With improving accuracy and efficiency of CT, some trauma centers have used a low threshold for the use of CT scans in the evaluation and assessment of trauma patients. The purpose of this study was to evaluate the diagnostic benefits of liberal CT scanning in multisystem blunt trauma motorcycle accident victims. The trauma registry at our community-based Level II center was accessed to identify consecutive motorcycle accident victims within a 55-month period who: 1) were evaluated on presentation by an attending trauma surgeon; and 2) underwent a head, cervical spine, chest, abdomen, or pelvis CT scan or any combination as part of their initial assessment. For those patients with clinically significant findings identified on CT, the percentage of those with negative clinical examinations was calculated. We found that 48, 77, 47, and 69 per cent of patients with clinically significant findings on head, cervical spine, thoracic, and abdominal CT, respectively, had normal clinical examinations. Our data suggest lower thresholds for CT use in the evaluation of patients sustaining multisystem blunt trauma should be adopted, even in the face of normal clinical examinations. This is especially true for the neck and abdominal regions.