{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:30:34Z","timestamp":1777447834758,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Extensive research relying on Injury Severity Scores (ISS) reports a mortality benefit from routine non-selective thoracic CTs (an integral part of pan-computed tomography (pan-CT)s). Recent research suggests this mortality benefit may be artifact. We hypothesized that the use of pan-CTs inflates ISS categorization in patients, artificially affecting admission rates and apparent mortality benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eight hundred and eleven patients were identified with an ISS &gt;15 with significant findings in the chest area. Patient charts were reviewed and scores were adjusted to exclude only occult injuries that did not affect treatment plan. Pearson chi-square tests and multivariable logistic regression were used to compare adjusted cases vs non-adjusted cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After adjusting for inflation, 388 (47.8%) patients remained in the same ISS category, 378 (46.6%) were reclassified into 1 lower ISS category, and 45 (5.6%) patients were reclassified into 2 lower ISS categories. Patients reclassified by 1 category had a lower rate of mortality ( P &lt; 0.001), lower median total hospital LOS ( P &lt; .001), ICU days ( P &lt; .001), and ventilator days ( P = 0.008), compared to those that remained in the same ISS category.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Injury Severity Score inflation artificially increases survival rate, perpetuating the increased use of pan-CTs. This artifact has been propagated by outdated mortality prediction calculation methods. Thus, prospective evaluations of algorithms for more selective CT scanning are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348211024973","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T06:37:15Z","timestamp":1623739035000},"page":"1600-1605","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Non-Selective Thoracic Computed Tomography in Trauma Patients Results in Injury Severity Score Inflation"],"prefix":"10.1177","volume":"87","author":[{"given":"Leonardo","family":"Alaniz","sequence":"first","affiliation":[{"name":"Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, CA, USA"},{"name":"School of Medicine, University of California, Irvine, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omaer","family":"Muttalib","sequence":"additional","affiliation":[{"name":"Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Hoyos","sequence":"additional","affiliation":[{"name":"Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesar","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Cristobal","family":"Barrios","sequence":"additional","affiliation":[{"name":"Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,6,15]]},"reference":[{"key":"bibr1-00031348211024973","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2009.10.035"},{"key":"bibr2-00031348211024973","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60232-4"},{"key":"bibr3-00031348211024973","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1408"},{"key":"bibr4-00031348211024973","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2005.12.009"},{"key":"bibr5-00031348211024973","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2011.06.003"},{"key":"bibr6-00031348211024973","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2009.04.005"},{"key":"bibr7-00031348211024973","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2017.03.048"},{"key":"bibr8-00031348211024973","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2007.03.016"},{"key":"bibr9-00031348211024973","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2012.10.002"},{"key":"bibr10-00031348211024973","doi-asserted-by":"publisher","DOI":"10.1177\/000313481007601008"},{"key":"bibr11-00031348211024973","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2010.08.004"},{"key":"bibr12-00031348211024973","doi-asserted-by":"publisher","DOI":"10.1177\/000313480907501023"},{"key":"bibr13-00031348211024973","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.03.015"},{"key":"bibr14-00031348211024973","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2015.03.033"},{"key":"bibr15-00031348211024973","unstructured":"Association for the Advancement of Automotive Medicine. Abbreviated injury scale (AIS). https:\/\/www.aaam.org\/abbreviated-injury-scale-ais\/. 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