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Is thorax CT necessary in emergency thoracic traumas?

Introduction: Recently, computed thorax tomography (Thorax CT) has replaced chest radiography as a routine imaging method in patients presenting to the emergency department after thoracic trauma. It has been shown that unnecessary use of thorax CT increases exposure to high-dose radiation, increases hospital costs, and prolongs the length of stay in the wards. Our study investigated the clinical necessity of thorax CT scans for patients who applied to our emergency department with thoracic trauma. Material Method: The data of 515 patients diagnosed with thoracic trauma in the emergency department between January 2017 and January 2021 were retrospectively reviewed. According to thorax CT findings, sternum fracture, diffuse parenchymal contusion, scapula fracture, presence of hemothorax, penetrating chest trauma, 3 or more costal fractures, vertebral fracture, diaphragm rupture, and mediastinal organ injury were evaluated as criteria showing that thorax CT was performed with a correct indication. Results: When we look at the thorax CT requirement criteria that we have determined, we saw that 391 (75.9%) patients had thorax CT performed with the correct indication, and 124 (24.1%) patients did not give us any additional pathological findings. Conclusion: As a result, we think that a good physical examination, evaluation of clinical findings, and performing thorax CT according to chest radiography findings will reduce unnecessary radiation exposure and hospital expenditure costs.