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Benefit of the Vittel criteria to determine the need for whole body scanning in a severe trauma patient.

Abstract :

OBJECTIVE: To evaluate the use of the Vittel criteria in addition to a clinical examination to determine the need for a whole body scan (WBS) in a severe trauma patient.

MATERIALS AND METHODS: Between December 2008 and November 2009, 339 severe trauma patients with at least one Vittel criterion were prospectively evaluated with a WBS. The following data were collected: the Vittel criteria present, circumstances of the accident, traumatic injury on the WBS, and irradiation. The original intent to prescribe a computed tomography (CT) scan (whole body or a targeted region), based solely on clinical signs, was specified.

RESULTS: Injuries were diagnosed in 55.75% of the WBS (n=189). The most common Vittel criteria were "global assessment" (n=266), "thrown, run over" (n=116), and "ejected from vehicle" (n=94). The multivariate analysis used the following as independent criteria for predicting severe traumatic injury on the WBS: Glasgow score less than 13, penetrating trauma, and colloid resuscitation greater than 11. Based solely on clinical factors, 164 patients would not have had any scan or (only) a targeted scan. In that case, 15% of the severe injuries would have been missed.

CONCLUSION: Using the Vittel criteria to determine the need for a WBS in a severe trauma patient makes it possible to find serious injuries not suspected on the clinical examination, but at the cost of an increased number of normal scans.

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https://hal.univ-angers.fr/hal-03405220
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Soumis le : mercredi 27 octobre 2021 - 10:30:22
Dernière modification le : jeudi 20 janvier 2022 - 12:18:02
Archivage à long terme le : : vendredi 28 janvier 2022 - 18:29:22

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J Babaud, Catherine Ridereau-Zins, Guillaume Bouhours, Jérôme Lebigot, R Le Gall, et al.. Benefit of the Vittel criteria to determine the need for whole body scanning in a severe trauma patient.. Diagnostic and Interventional Imaging, Elsevier, 2012, 93, pp.371-379. ⟨10.1016/j.diii.2012.02.007⟩. ⟨hal-03405220⟩

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