Fig. 4.

Cost-effectiveness of immediate total-body CT versus standard work-up in patients with traumatic brain injury

a,c Cost-effectiveness plane based on 5000 bootstrap resamples showing differences in hospital healthcare costs and proportions of patients alive at 6 months with or without serious morbidity (a) and without serious morbidity (c) between immediate total-body CT (iTBCT) and standard workup. Larger dots represent higher bootstrap counts (scale legend). iTBCT may be more costly and more effective (upper right quadrant), more costly and less effective (upper left), cheaper and less effective (lower left), or cheaper and more effective (lower right). b,d Cost-effectiveness acceptability curve showing the probability of iTBCT being cost-effective for different values of willingness to pay up to €500 000 per patient alive at 6 months with or without serious morbidity (b) and without serious morbidity (d).

The effect of immediate total-body CT (iTBCT) on health economic aspects in patients with severe trauma is an underreported issue. This study (REACT-2) determined the cost-effectiveness of iTBCT compared with conventional radiological imaging with selective CT during the initial trauma evaluation. Economically, from a hospital healthcare provider perspective, iTBCT should be the diagnostic strategy of first choice in patients with multiple trauma or traumatic brain injury.