Evaluation of Clinical Criteria for Performing Brain CT-Scan in Patients with Mild Traumatic Brain Injury; A New Diagnostic Probe

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Molaei Langroudi Roghieh; ALIZADEH AHMAD; KAZEMNEJAD LEILI EHSAN; MONSEF KASMAIE VAHID; Moshirian Seyed Younes

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Journal Paper

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Journal: Bulletin of Emergency And Trauma Year:2019 | Volume:7 | Issue:3 Page(s): 269-277

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Title

Evaluation of Clinical Criteria for Performing Brain CT-Scan in Patients with Mild Traumatic Brain Injury; A New Diagnostic Probe

Author(s)

Keywords

Computerized tomography (CT)-scan

Traumatic brain injury (TBI)

Criteria

Clinical

Brain

Abstract

Objective: To investigate the risk factors that can be proper indications for performing Brain computerized tomography (CT)-scan in patients with mild and moderate traumatic Brain injury (TBI) in order to avoid unnecessary exposure to radiation, saving on costs as well as time wasted in emergency wards. Methods: Data of patients with mild traumatic Brain injury (TBI) referring to Emergency Department with age ≥ 2 years and primary GCS of 13-15 were examined including focal neurological deficit, anisocoria, skull fracture, multiple trauma, superior injury of clavicle, decreased consciousness, and amnesia. Brain CT-scan was performed in all the patients. Kappa Coefficient was used to determine the ratio of agreement of the CT indications (+ and-) and multiple logistic regression to determine the relative odds of positive CTs. Results: Overall we included 610 patients. One-hundred and one patients (16. 5%) had positive and 509 (83. 5%) had negative CT findings. Of positive CTs, the highest percentage was dedicated to high-energy mechanism of trauma. High-energy trauma mechanism (OR=1. 056, 95% CI, OR, 1. 03-1. 04, p<0. 001), superior injury of clavicle (OR=1. 07, 95% CI, OR, 1. 03-1. 1, p<0. 001) and moderate to severe headache (OR=1. 04, 95% CI, OR, 1. 02-1. 05, p<0. 001) were positive predictors of CT findings. The combined mean of positive symptoms equaled 0. 290. 64± in negative CTs, but 5. 132. 4± in positive CTs, showing a significant difference. (p<0. 001) Conclusion: Abnormal positive Brain CT in victims with mild TBI is predictable if one or several risk factors are taken into account such as moderate to severe headache, decreased consciousness, skull fracture, highenergy trauma mechanism, superior injury of clavicle and GCS of 13-14. The more the symptoms, the more likely the positive CT results would be.

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References

Routine repeat head CT may not be necessary for patients with mild TBI

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APA: Copy

Molaei Langroudi, Roghieh, ALIZADEH, AHMAD, KAZEMNEJAD LEILI, EHSAN, MONSEF KASMAIE, VAHID, & Moshirian, Seyed Younes. (2019). Evaluation of Clinical Criteria for Performing Brain CT-Scan in Patients with Mild Traumatic Brain Injury; A New Diagnostic Probe. BULLETIN OF EMERGENCY AND TRAUMA BEAT, 7(3), 269-277. SID. https://sid.ir/paper/335175/en

Vancouver: Copy

Molaei Langroudi Roghieh, ALIZADEH AHMAD, KAZEMNEJAD LEILI EHSAN, MONSEF KASMAIE VAHID, Moshirian Seyed Younes. Evaluation of Clinical Criteria for Performing Brain CT-Scan in Patients with Mild Traumatic Brain Injury; A New Diagnostic Probe. BULLETIN OF EMERGENCY AND TRAUMA BEAT[Internet]. 2019;7(3):269-277. Available from: https://sid.ir/paper/335175/en

IEEE: Copy

Roghieh Molaei Langroudi, AHMAD ALIZADEH, EHSAN KAZEMNEJAD LEILI, VAHID MONSEF KASMAIE, and Seyed Younes Moshirian, “Evaluation of Clinical Criteria for Performing Brain CT-Scan in Patients with Mild Traumatic Brain Injury; A New Diagnostic Probe,” BULLETIN OF EMERGENCY AND TRAUMA BEAT, vol. 7, no. 3, pp. 269–277, 2019, [Online]. Available: https://sid.ir/paper/335175/en

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