Validity of bone scans to detect missed injury in major trauma patients [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. Ahead of Print: UTD-55068 | DOI: 10.5505/tjtes.2018.55068  

Validity of bone scans to detect missed injury in major trauma patients

Maru Kim, Tae Hwa Hong, Hang Joo Cho
Department of Trauma Surgery, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea

Background It is easy to miss injuries in major trauma patients. The authors hypothesized that bone scans (BS) would reduce the number of missed injuries. However, there was not enough evidence on BS in major trauma patients. The purpose of this study is to identify the basic results of BS in major trauma patients.
Methods Medical records of major trauma patients between January 2013 and December 2013 were reviewed and patients who underwent a BS were enrolled in the analysis. Hot-uptake lesions without previous evaluation were checked by X-ray. Hot-uptake lesions on bone scans that differed from previous evaluations were checked with CT scans. The results of bone scans were analyzed along with the results of X-ray and CT scans. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated.
Results There were 115 major trauma patients who received BS during the period. The sensitivities were high on average (98.48 – 86.54). Also, the negative predictive values were high (96.30 – 82.93). There were 16 cases of hidden fracture diagnosed after a BS.
Conclusions BS showed high sensitivity and high negative predictive value. Further large-scale studies might add more validity to the use of BS in major trauma patients.

Keywords: Bone scan, Missed injury, Tertiary survey, Trauma

Corresponding Author: Hang Joo Cho, South Korea

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