Sonja Kirchhoff MD, Presenter: Nothing to Disclose

Oliver Peschel, Abstract Co-Author: Nothing to Disclose

Stefanie Kurz, Abstract Co-Author: Nothing to Disclose

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

The aim was to analyze the conclusiveness of post mortem Computed Tomography (pmCT) regarding a reliable and adequate cause of death in trauma patients who died either in the trauma room or during emergency surgeries after the decision was made to terminate resuscitation procedures in comparison to the gold standard autopsy, and to help in matters of quality control, research and teaching..

Data of trauma patients mostly due to traffic accidents admitted to the trauma room of our University Level I trauma center were enrolled and retrospectively analyzed. Subsequently pmCT followed by autopsy were performed. The cause of death, types and body region of injuries were analyzed and compared respectively. For the CT scans medical equipment placed in the patients such as intubation tubes, intravenous canules, etc. was not removed. PmCT was also searched for an explanation if an unsuccessful resuscitation took place.

17 patients were enrolled. 8 patients sustained deadly injuries to the head (47.1%), 11 to the chest (64.7%), 0 to the abdomen (0%), 4 to the skeletal system (23.5%) and one patient drowned (5.8%). In 52.9% of the cases (group I) good agreement of autopsy and pmCT resulted. In 41.2 % autopsy provided superior results compared to pmCT (group II) whereas in 5.8% pmCT found more information compared to autopsy (group III). PmCT was especially useful for the diagnosis of fractures, cerebral injuries and detecting gas formation of all kinds. Autopsy was superior in finding and interpreting injuries to parenchymal organs and vessels.

PmCT is useful in persons who died due to trauma providing quick results and a detailed overview of especially bony lesions, but also brain injuries and gas formations. It is advisable to conduct pmCT especially in cases without consent to autopsy to gain information about possible causes of death and to rule out the possibility of clinical mistakes, therefore to assure quality control.

PmCT can gain worthy information about injury patterns, especially of the skeletal system, head and brain after traumatic death. In cases when autopsy is declined, CT can outline a noninvasive alternative to evaluate diagnosis and therapy.

Kirchhoff, S, Peschel, O, Kurz, S, Reiser, M, Analysis of Causes of Death and Injury Patterns in Multiple Trauma: A Comparison of Post Mortem Computed Tomography (pmCT) to the Gold Standard Autopsy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045554.html