PDF(Pubmed)
Abstract：
OBJECTIVE: This study aimed to evaluate the cost vs. benefits of the CT face imaging study in the trauma workup of those over the age of 65.
METHODS: We performed a retrospective chart review of 169 trauma patients in our trauma database aged 65 years or older who underwent a CT of the head, a CT of the face, or a CT of the head and CT of the face that resulted in findings of a facial fracture from 2017-2022. Injuries and the treatment they received were documented. If a patient underwent both a CT of the face and a CT of the head, then the author first viewed the CT of the head, documented any injury, and then recorded treatment based on the CT of the head. The CT of the face was then viewed, injuries were recorded, and treatment based on the CT of the face was documented. Statistical analysis was then performed using the paired T-test, McNemar test, and number needed to harm analysis.
RESULTS: Of the 169 patients sampled, 159 underwent both CT of the head and the face. There were no patients who underwent a CT of the face exclusively, and only 10 patients underwent a CT of the head exclusively. Of the 159 that had both a CT of the head and the face, the average number of injuries noted on CT of the head + CT of the face vs. CT of the head was 2.42 vs. 1.36, P<.0.0001. The number needed to avoid missing a surgical facial fracture when only a CT of the head was obtained was 14.68.
CONCLUSIONS: The risks of missing a surgical facial fracture outweigh the monetary, radiation, and patient-desired necessity benefits of only performing a CT of the head. A CT of the face should be included in the trauma workup for those over the age of 65 when facial fractures are suspected.
METHODS: We performed a retrospective chart review of 169 trauma patients in our trauma database aged 65 years or older who underwent a CT of the head, a CT of the face, or a CT of the head and CT of the face that resulted in findings of a facial fracture from 2017-2022. Injuries and the treatment they received were documented. If a patient underwent both a CT of the face and a CT of the head, then the author first viewed the CT of the head, documented any injury, and then recorded treatment based on the CT of the head. The CT of the face was then viewed, injuries were recorded, and treatment based on the CT of the face was documented. Statistical analysis was then performed using the paired T-test, McNemar test, and number needed to harm analysis.
RESULTS: Of the 169 patients sampled, 159 underwent both CT of the head and the face. There were no patients who underwent a CT of the face exclusively, and only 10 patients underwent a CT of the head exclusively. Of the 159 that had both a CT of the head and the face, the average number of injuries noted on CT of the head + CT of the face vs. CT of the head was 2.42 vs. 1.36, P<.0.0001. The number needed to avoid missing a surgical facial fracture when only a CT of the head was obtained was 14.68.
CONCLUSIONS: The risks of missing a surgical facial fracture outweigh the monetary, radiation, and patient-desired necessity benefits of only performing a CT of the head. A CT of the face should be included in the trauma workup for those over the age of 65 when facial fractures are suspected.
摘要：
目的：本研究旨在评估成本与CT面部成像研究在65岁以上人群的创伤检查中的益处。
方法：我们对我们的创伤数据库中的169名年龄在65岁或以上的患者进行了头部CT检查，面部CT,或2017-2022年导致面部骨折的头部CT和面部CT。记录了他们的伤害和接受的治疗。如果患者同时进行了面部CT和头部CT，然后作者首先看了头部的CT，记录任何伤害，然后根据头部的CT记录治疗。然后看了面部的CT,受伤记录，并记录了基于面部CT的治疗。然后使用配对T检验进行统计分析，McNemar测试,和伤害分析所需的数量。
结果：在抽样的169名患者中，159人接受了头部和面部的CT检查。没有患者只接受面部CT检查，只有10例患者接受了头部CT检查。在头部和面部都有CT的159人中，头部CT+面部CT上记录的平均损伤数与头部CT为2.42vs.1.36,P<.0.0001。当仅获得头部CT时，避免错过外科面部骨折所需的数量为14.68。
结论：错过外科面部骨折的风险大于金钱，辐射,以及仅执行头部CT的患者期望的必要性益处。对于怀疑面部骨折的65岁以上的人，应在创伤检查中包括面部CT。
方法：我们对我们的创伤数据库中的169名年龄在65岁或以上的患者进行了头部CT检查，面部CT,或2017-2022年导致面部骨折的头部CT和面部CT。记录了他们的伤害和接受的治疗。如果患者同时进行了面部CT和头部CT，然后作者首先看了头部的CT，记录任何伤害，然后根据头部的CT记录治疗。然后看了面部的CT,受伤记录，并记录了基于面部CT的治疗。然后使用配对T检验进行统计分析，McNemar测试,和伤害分析所需的数量。
结果：在抽样的169名患者中，159人接受了头部和面部的CT检查。没有患者只接受面部CT检查，只有10例患者接受了头部CT检查。在头部和面部都有CT的159人中，头部CT+面部CT上记录的平均损伤数与头部CT为2.42vs.1.36,P<.0.0001。当仅获得头部CT时，避免错过外科面部骨折所需的数量为14.68。
结论：错过外科面部骨折的风险大于金钱，辐射,以及仅执行头部CT的患者期望的必要性益处。对于怀疑面部骨折的65岁以上的人，应在创伤检查中包括面部CT。
