| Identifying risk factors for an abnormal computed tomographic scan of the head among patients with altered mental status in the Emergency Department. | |
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MedLine Citation:
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PMID: 19773662 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: The aims of our study are to evaluate the use of computed tomographic scan of the head (CT-head) in patients with altered mental status (AMS) presenting to the Emergency Department (ED) and to identify clinical features associated with an abnormal CT-head result. METHODS: In this prospective observational study, we recruited consecutive adult patients with undifferentiated AMS and no major trauma at a busy urban ED over 11 months. Demographical, clinical, radiological and laboratory data were collected prospectively. The primary outcome measure was an abnormal CT-head result. Secondary outcome measures were the distribution of aetiologies of AMS with age, mortality rate and length of hospital stay. Logistic regression was applied to identify variables associated with an abnormal CT-head result. RESULTS: Nine hundred and sixty-seven patients were recruited. The rate of CT-head use in the ED was 41%, with 45% of the scans being abnormal. We identified eight clinical factors associated with an abnormal CT-head result. Odds ratios (95% confidence intervals) for diastolic blood pressure greater than 80 mmHg, focal weakness, Glasgow Coma Score less than 15, antiplatelet use, upgoing plantar response, presence of headache, anticoagulant use and dilated pupils were 1.016 (1.003-1.029), 1.816 (1.063-3.103), 1.899 (1.113-3.242), 2.203 (1.146-4.234), 2.680 (1.623-4.427), 3.369 (1.449-7.830), 3.589 (1.253-10.283) and 5.212 (1.153-23.558), respectively. CONCLUSION: Our study identified important risk factors for an abnormal CT-head result which can be used in future research to establish a guideline for rational ordering of the test in AMS patients. |
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Authors:
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Lim Beng Leong; Kenneth Heng Wei Jian; Alicia Vasu; Eillyne Seow |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: European journal of emergency medicine : official journal of the European Society for Emergency Medicine Volume: 17 ISSN: 1473-5695 ISO Abbreviation: Eur J Emerg Med Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-06-30 Completed Date: 2010-10-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9442482 Medline TA: Eur J Emerg Med Country: England |
Other Details:
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Languages: eng Pagination: 219-23 Citation Subset: IM |
Affiliation:
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Emergency Department, Tan Tock Seng Hospital, Singapore. Beng_Leong_Lim@ttsh.com.sg |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Age Factors Aged Anticoagulants / adverse effects Confusion / etiology*, mortality Female Head / radiography* Humans Male Middle Aged Platelet Aggregation Inhibitors / adverse effects Prospective Studies Risk Factors Tomography, X-Ray Computed* Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Platelet Aggregation Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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