Document Detail


A retrospective cohort study to re-evaluate clinical correlates for intracranial injury in minor head injury.
MedLine Citation:
PMID:  22158527     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
IntroductionThe aim of this study was to determine the Relative Risk (RR) ratios for common clinical correlates in adult patients with minor head injury in a cohort of patients in which loss of consciousness (LOC) and post-traumatic amnesia (PTA) were not the only entry criteria for CT scanning.MethodsThe computerised CT request notes were reviewed on all patients who underwent a CT head scan with a minor head injury over a 1-year period (January 2009-December 2009). The clinical signs and symptoms at presentation were extracted from the request notes and the RR ratios were calculated for five clinical correlates: LOC, PTA, vomiting, nausea and headache.Results456 Glasgow coma scale (GCS) 15 patients underwent CT scanning during the period January 2009-December 2009. 55 of the 456 patients had positive CT findings (12%). 270 patients (59%) of the GCS 15 cohort had neither LOC nor PTA and of this subgroup 27 had positive scans. LOC was the only clinical correlate in which the RR reached statistical significance; RR 2.0930 (95% CI 1.25 to 3.50). However, vomiting accounted for four cases, headache for four cases and nausea for no cases.ConclusionsUsing LOC or PTA as the principal entry criterion for CT scanning may result in a significant number of patients with traumatic intracranial injury being missed. Using a less stringent approach still achieved an acceptable CT abnormality rate.
Authors:
Alison Sheehan; John S Batchelor
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-8
Journal Detail:
Title:  Emergency medicine journal : EMJ     Volume:  -     ISSN:  1472-0213     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963089     Medline TA:  Emerg Med J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Emergency Medicine, Manchester Royal Infirmary, Manchester, UK.
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