Martin Helmut Maurer MD, Presenter: Nothing to Disclose

Annegret Winkler, Abstract Co-Author: Nothing to Disclose

Florian Wichlas, Abstract Co-Author: Nothing to Disclose

Maciej Powerski, Abstract Co-Author: Nothing to Disclose

Florian Elgeti, Abstract Co-Author: Nothing to Disclose

Alexander Huppertz MD, Abstract Co-Author: Employee, Siemens AG

Rainer Röttgen MD, PhD, Abstract Co-Author: Nothing to Disclose

Tim Marnitz, Abstract Co-Author: Nothing to Disclose

To assess the costs and diagnostic gain of abdominal ultrasound follow-up of polytrauma patients initially examined by whole-body computed tomography (CT).

A total of 176 polytrauma patients (126 male, 50 female; age 43.5±17.4 years) were retrospectively analyzed with regard to supplementary and new findings obtained by ultrasound follow-up compared with the results of exploratory FAST (focused assessment with sonography for trauma) on admission and the findings of whole-body CT. A process model was used to document the staff, material, and total costs of the ultrasound follow-up examinations.

FAST ultrasound yielded 26 abdominal findings (organ injury and/or free intra-abdominal fluid) in 19 patients, while the abdominal scan of whole-body CT revealed 32 findings in 25 patients. FAST had 81% sensitivity and 100% specificity. Follow-up ultrasound examinations revealed new findings in two of the 25 patients with abdominal injuries detected at initial CT. In the 151 patients without abdominal injuries on the initial CT scan, ultrasound follow-up yielded no supplementary or new findings. The total costs of an ultrasound follow-up examination were USD 40.05. The total costs of all follow-up ultrasound examinations performed in the study population were USD 7035.34.

Follow-up abdominal ultrasound shows a low overall diagnostic gain in polytrauma patients in whom initial CT fails to detect any abdominal injuries but causes high personnel expenses for radiologic departments.

In polytrauma patients without abdominal findings in the initial CT scan follow-up ultrasound of the abdomen might be dispensable.

Maurer, M, Winkler, A, Wichlas, F, Powerski, M, Elgeti, F, Huppertz, A, Röttgen, R, Marnitz, T, Costs and Role of Ultrasound Follow-up of Polytrauma Patients after Initial Computed Tomography.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11008981.html