目的:计算机断层扫描肺动脉造影(CTPA)是用于检测肺栓塞(PE)的标准成像技术。本系统综述和荟萃分析旨在研究接受CTPA的创伤患者中PE的患病率。
方法:对PubMed的全面搜索,Scopus,谷歌学者,和WebofScience进行了13项研究,涉及5,570名个体,这些研究遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目进行。选择在创伤患者中使用CTPA检测PE的研究。这导致了对患病率的评估,创伤类型,临床表现,放射学发现,接受CTPA的创伤患者的PE死亡率。
结果:接受CTPA的创伤患者中PE的总体患病率为18%(95%CI=13-24%)。汇集现有数据后,股骨骨折被确定为最常见的创伤类型(12%)。创伤患者中最常见的PE临床表现包括呼吸急促,胸痛,改变了生命体征.放射学发现包括各种肺部异常,比如不透明度,毛玻璃不透明,和胸腔积液.在纳入的研究中,创伤患者的PE死亡率为0%至29.4%。
结论:这项研究提供了对患病率的全面见解,临床表现,接受CTPA的创伤患者中PE的放射学发现和死亡率。根据我们的发现,对于下肢或脊柱骨折患者,建议CTPA的阈值较低.
OBJECTIVE: Computed tomography pulmonary angiography (CTPA) is a standard imaging technique employed for the detection of pulmonary embolism (PE). This systematic
review and meta-analysis aims to examine the prevalence of PE among the trauma patients undergoing CTPA.
METHODS: A comprehensive search across PubMed, Scopus, Google Scholar, and Web of Science yielded 13 studies encompassing 5,570 individuals conducted following Preferred Reporting Items for Systematic
Review and Meta-Analysis (PRISMA) guideline. Studies that used CTPA for the detection of PE among the trauma patients were selected. This resulted in an evaluation of prevalence, trauma types, clinical manifestations, radiological findings, and mortality rates of PE among traumatic patients undergoing CTPA.
RESULTS: The overall prevalence of PE among trauma patients undergoing CTPA was 18% (95% CI = 13-24%). After pooling the existing data, femur fractures were determined to be the most prevalent trauma type (12%). The most prevalent clinical manifestations of PE among trauma patients included shortness of breath, chest pain, and altered vital signs. Radiological findings encompassed various pulmonary abnormalities, such as opacity, ground-glass opacities, and pleural effusions. Mortality rates of PE among the trauma patients ranged from 0% to 29.4% across the included studies.
CONCLUSIONS: This study provides comprehensive insights into the prevalence, clinical manifestations, radiological findings and mortality of PE among trauma patients undergoing CTPA. According to our findings, lower threshold for CTPA is recommended in patients with lower extremity or spine fractures.