Efficacy of pan-computed tomography scan in trauma patients presenting in the emergency department of a tertiary care center: an observational study

Background: The use of pan-computed tomography (pan-CT) in trauma care has gained widespread popularity due to its ability to identify life-threatening multi-system injuries. However, concerns remain regarding its liberal use, radiation exposure, and cost-effectiveness, especially in the absence of clear clinical indications. Methods: This cross-sectional analytical study was conducted at a tertiary care center from May 2023 to April 2025. Records of 313 trauma patients who underwent pan-CT in the emergency department were analyzed. Pan-CT scans were divided into five anatomical zones, and findings were classified as major or minor injuries. Injury Severity Score (ISS) was used to stratify patients into ISS <16 and ≥ 16 groups. Chi-square test and binary logistic regression were used for analysis. Results: Among 313 patients, 257 (82.1%) had positive findings in at least one body region, 166 (53.03%) in two or more regions, and 56 (17.89%) in three or more regions. Emergency interventions were required in 14.4% of patients, and 10.9% underwent additional contrast-enhanced scans. Patients with ISS ≥ 16 had significantly higher positivity rates in the head (OR = 2.55, 95% CI 1.61–4.03, P < 0.001) and chest (OR = 1.96, 95% CI 1.24–3.11, P = 0.004) regions. However, only 14% underwent emergency procedures despite the high positivity rate. Conclusion: Pan-CT scans demonstrated high positivity rates, especially in patients with ISS >16 and injuries to the head and chest. While effective in detecting injuries, the clinical utility must be balanced with judicious use, and further studies are warranted to establish standardized indications for pan-CT in trauma care.