ORIGINAL ARTICLE
CT SCANNING WITH POLYTRAUMA PROTOCOL: IS THE PATIENT OVER-SCANNED?

UDK: 616-001-073.756.8:004

Spirkoska Jovanov I1,2,3,4, Jakimovska Dimitrovska M2,3, Vasilevska Nikodinovska V2,4

1General Hospital “BorkaTaleski” Prilep, Macedonia

2University “Ss Cyril and Methodius”, Skopje, Macedonia

3Institute of Radiology, Skopje, Macedonia

4University Clinic for Surgical Disease “St. Naum Ohridski” Skopje, Macedonia

 

Abstract

Trauma is the leading cause of death in individuals under 45 years old. CT scan with polytrauma protocol plays a crucial role in the rapid assessment of trauma patients. However, its routine usage may result in unnecessary imaging, increased radiation exposure and higher healthcare costs.

This study aimed to evaluate the overuse of CT scans performed with polytrauma protocol based on clinician’s request.

Materials and Methods: A retrospective review of 138 trauma patients referred to polytrauma CT scans between March and May 2025, that was conducted using PACS data from two institutions. The average patients’ age was 46.3 years (range: 4–89 years), with 79% being male.

Inclusion criteria were trauma patients referred to CT with polytrauma protocol. The number of injured body parts was compared to the number of parts scanned to assess scan necessity.

Results: Out of 138 patients 49 (35.5%) had positive CT findings. Out of 49 patients 32 (65.3%) met polytrauma criteria. Only 4 patients (8.2%) had indication for CT scan with polytrauma protocol. 45 (91.8%) of the patients were over-scanned. 75% excess scanning had 17 patients (37.7%), 50% over-scanning had 20 patients (44.4%), and 25% over-scanning was done in 7 patients (15.5%). The most unnecessary examinations were performed to neck in 85.7% and abdomen in 46.6%, in comparison to chest (33.3%).

Conclusion: A significant number of patients underwent unnecessary CT scanning, particularly involving the neck and abdomen. These findings underscore the importance of clinical guidelines to reduce over-scanning, minimize radiation, lower costs and improve trauma care efficiency.

Key Words:  CT polytrauma protocol; over-scanning.

 

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