| Title | Predictors of positive CT scans in the trauma patient with minor head injury. | | Author(s) | Moran SG, McCarthy MC, Uddin DE, Poelstra RJ | | Institution | Department of Surgery, Wright State Univeristy School of Medicine, Dayton, Ohio. | | Source | Am Surg 1994 Jul; 60(7):533-5; discussion 535-6. | | MeSH | Adolescent
Adult
Aged
Aged, 80 and over
Brain Injuries
Child
Craniocerebral Trauma
Emergency Service, Hospital
Female
Glasgow Coma Scale
Humans
Male
Middle Aged
Patient Admission
Predictive Value of Tests
Retrospective Studies
Skull Fractures
Tomography, X-Ray Computed
Triage
| | Abstract | Routine cerebral CT scanning of patients with minor head injuries has been advocated as a screening procedure for hospital admission. The purpose of this study was to determine whether there were characteristics of the trauma patient with a minor head injury. Glasgow Coma Scale (GCS) of 13-15, that would predict a positive cerebral CT scan. An analysis of 200 patients with potential head injuries transported to our regional trauma center was performed. The following characteristics were analyzed as possible predictors: scene GCS (SC-GCS), emergency room GCS (ER-GCS), a change in GCS from scene to emergency room, loss of consciousness (LOC), and focal neurological deficit. Forty-eight per cent (96/200) of the patients underwent CT scanning of the head. CT scans were positive in 4 per cent (8/200) of the total group and 8.3 per cent (8/96) of those who underwent CT scanning. In the patients without LOC and ER-GCS of 13-15, all CT scans were negative (95% confidence interval 0.0% to 3.4%). In the 93 patients with LOC, eight patients had a positive scan (P < 0.001). Of the nine patients who sustained a skull fracture, five had a positive CT (55.6%; 95% confidence interval 21.2% to 86.3%) (P < 0.0001). Of all the patients with positive CT scans, two underwent emergent craniotomy: one for a depressed skull fracture with underlying contusion, the other for a temporal bone fracture and an epidural hematoma. Both patients had LOC and SC-GCS and ER-GCS of 15.(ABSTRACT TRUNCATED AT 250 WORDS) | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 8010569 |
|
