BACKGROUND Trauma is a major source of morbidity and mortality, especially in people below the age of 50 years. For the evaluation of trauma patients CT scanning has gained wide acceptance in and provides detailed information on location and severity of injuries. However, CT scanning is frequently time consuming due to logistical (location of CT scanner elsewhere in the hospital) and technical issues. An innovative and unique infrastructural change has been made in the AMC in which the CT scanner is transported to the patient instead of the patient to the CT scanner. As a consequence, early shockroom CT scanning provides an all-inclusive multifocal diagnostic modality that can detect (potentially life-threatening) injuries in an earlier stage, so that therapy can be directed based on these findings. METHODS/DESIGN The REACT-trial is a prospective, randomized trial, comparing two Dutch level-1 trauma centers, respectively the VUmc and AMC, with the only difference being the location of the CT scanner (respectively in the Radiology Department and in the shockroom). All trauma patients that are transported to the AMC or VUmc shockroom according to the current prehospital triage system are included. Patients younger than 16 years of age and patients who die during transport are excluded. Randomization will be performed prehospitally. Study parameters are the number of days outside the hospital during the first year following the trauma (primary outcome), general health at 6 and 12 months post trauma, mortality and morbidity, and various time intervals during initial evaluation. In addition a cost-effectiveness analysis of this shockroom concept will be performed. Regarding primary outcome it is estimated that the common standard deviation of days spent outside of the hospital during the first year following trauma is a total of 12 days. To detect an overall difference of 2 days within the first year between the two strategies, 562 patients per group are needed. (alpha 0.95 and beta 0.80). DISCUSSION The REACT-trial will provide evidence on the effects of a strategy involving early shockroom CT scanning compared with a standard diagnostic imaging strategy in trauma patients on both patient outcome and operations research. TRIAL REGISTRATION ISRCTN55332315.

中文翻译：

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对位于 Shockroom 的 CT 扫描仪的评估：一项随机研究，通过 CT 扫描对荷兰西北部双地点创伤中心的创伤患者进行早期评估（REACT 试验）。

背景创伤是发病率和死亡率的主要来源，尤其是在 50 岁以下的人群中。对于创伤患者的评估，CT 扫描已获得广泛接受，并提供有关损伤​​位置和严重程度的详细信息。然而，由于后勤（CT 扫描仪在医院其他地方的位置）和技术问题，CT 扫描通常很耗时。在 AMC 中进行了创新和独特的基础设施更改，其中 CT 扫描仪被运送到患者身上，而不是将患者运送到 CT 扫描仪。因此，早期休克室 CT 扫描提供了一种包罗万象的多焦点诊断方式，可以在早期发现（可能危及生命的）损伤，以便根据这些发现指导治疗。方法/设计 REACT 试验是一项前瞻性、随机试验，比较了两个荷兰 1 级创伤中心，分别是 VUmc 和 AMC，唯一的区别是 CT 扫描仪的位置（分别位于放射科和休克室）。包括根据当前院前分诊系统运送到 AMC 或 VUmc 休克室的所有创伤患者。年龄小于 16 岁的患者和在运输过程中死亡的患者被排除在外。随机化将在院前进行。研究参数是创伤后第一年的住院天数（主要结果）、创伤后 6 个月和 12 个月的总体健康状况、死亡率和发病率以及初始评估期间的不同时间间隔。此外，还将对该休克室概念进行成本效益分析。关于主要结果，估计创伤后第一年在医院外度过的天数的共同标准差总计为 12 天。为了检测两种策略之间第一年内 2 天的总体差异，每组需要 562 名患者。（alpha 0.95 和 beta 0.80）。讨论 REACT 试验将提供证据，证明与创伤患者的标准诊断成像策略相比，涉及早期休克室 CT 扫描的策略对患者结果和手术研究的影响。试用注册 ISRCTN55332315。每组需要 562 名患者。（alpha 0.95 和 beta 0.80）。讨论 REACT 试验将提供证据，证明与创伤患者的标准诊断成像策略相比，涉及早期休克室 CT 扫描的策略对患者结果和手术研究的影响。试用注册 ISRCTN55332315。每组需要 562 名患者。（alpha 0.95 和 beta 0.80）。讨论 REACT 试验将提供证据，证明与创伤患者的标准诊断成像策略相比，涉及早期休克室 CT 扫描的策略对患者结果和手术研究的影响。试用注册 ISRCTN55332315。