Meltzer JA, et al. - Authors probed into the correlation between emergent whole-body computed tomography (WBCT) with lower mortality among children with blunt trauma compared with a selective CT approach using data from the National Trauma Data Bank on children aged 6 months to 14 years with blunt trauma who received an emergent CT scan in the first 2 hours after Emergency Department arrival. No link was disclosed between WBCT with lower mortality compared with a selective CT approach among children with blunt trauma. Therefore, yielded data did not validate the routine use of WBCT for children with blunt trauma.

Methods

• This retrospective, multicenter cohort study was performed from January 1, 2010, to December 31, 2014.
• Using data from the National Trauma Data Bank, children aged 6 months to 14 years with blunt trauma were analyzed who received an emergent CT scan in the first 2 hours after Emergency Department arrival.
• From February 2 to December 29, 2017 the data analysis was carried out.
• Enrollees were classified as having WBCT if they received CT head, CT chest, and CT abdomen/pelvis scans in the first 2 hours and as having a selective CT if they did not receive all 3 scans.
• The primary outcome included in-hospital mortality in the 7 days after ED arrival.
• The propensity score weighting aided in adjusting potential confounding.
• Subgroup analyses were conducted for those with the highest mortality risk (ie occupants and pedestrians involved in motor vehicle crashes, children with a Glasgow Coma Scale score lower than 9, children with hypotension, and those admitted to the intensive care unit).

Results

• Among the 42,912 children (median age [interquartile range], 9 [5-12] years; 27,861 [64.9%] boys), 8,757 (20.4%) received a WBCT.
• Death was reported in 405 (0.9%) children within 7 days.
• As per the outcomes, children who received WBCT did not display any prominent variation in mortality compared with those who received selective CT (absolute risk difference, -0.2%; 95% CI, -0.6% to 0.1%) after adjusting for the propensity score.
• All subgroup analyses did not demonstrate significant correlation between WBCT and mortality.