Thoracic computed tomography in intensive care patients - Evaluation of clinical usefulness

Purpose: Computed tomography of intensive care patients requires transportation of the patient to the radiology department. This study analyses, whether this consumption of resources is justified by therapeutical and diagnostic consequences derived from helical computertomography of the chest. Methods: 558 CT studies of the chest were compared with current bedside chest radiographs. The additional information of CT scans and their consequences were evaluated retrospectively. Results: 388 (69.5%) of these computed tomographies provided additional information compared with projection radiographs. 374 therapeutical procedures resulted from 266 (68.6%) out of these 388 CT examinations. These therapeutical interventions were significantly more invasive than those 144 procedures derived from 170 (30.5%) CT studies which did not show any additional findings compared with bedside chest radiographs. Conclusion: in more than two thirds (69.5%) additional diagnoses were found with computertomography. Nearly one half of the CT studies resulted in additional Findings and therapeutical consequences. Invasive therapeutical consequences were based on CT studies significantly more frequently than on bedside chest radiographs.