CT interpretations in multiply injured patients: comparison of emergency physicians and on-call radiologists.

ABSTRACT

OBJECTIVE: In this study, emergency physicians and on-call radiologists were compared regarding identification of fatal injuries on computed tomographic (CT) scans in patients with trauma. MATERIALS AND METHODS: Multiply injured patients who were older than 18 years and underwent CT scanning were included in the study. The CT scans were interpreted by the responsible emergency physician. At the same time, these images were also evaluated by the on-call radiologist. Final evaluation was done 1 week later by a radiology instructor who knew the clinical follow-up of the patient. RESULTS: The study included 156 patients. The mean age of the patients included in the study was found to be 41.6 years. Less than half (33.5%) of the patients were female and 86.5% were male. A total of 482 CT scans were performed in the patients. Regarding brain CTs, the concordance rate for emergency physicians was 98%, whereas it was 94% for on-call radiologists. Regarding thoracic CTs, the concordance rate for emergency physicians was 91%, whereas was 93% for on-call radiologists. There was a perfect concordance (κ value > 0.75) for on-call radiologists and emergency physicians in terms of brain and thoracic CTs. Regarding abdominal-pelvic CTs, the concordance rate for emergency physicians was 97%, whereas it was 98% for on-call radiologists. Moderate concordance (κ range = 0.40-0.75) was detected for emergency physicians in terms of identification of liver, spleen, kidney, and intra-abdominal/retroperitoneal hemorrhages. There was a perfect concordance (κ value > 0.75) for pelvic fractures. CONCLUSION: In this study, it was shown that emergency physicians were successful in identifying fatal injuries on trauma CT images after a short-term training on interpretation of trauma CTs.