Predictors of New Findings on Repeat Head CT Scan in Blunt Trauma Patients with an Initially Negative Head CT Scan

Title

Predictors of New Findings on Repeat Head CT Scan in Blunt Trauma Patients with an Initially Negative Head CT Scan

Creator

Muakkassa F F; Marley R A; Paranjape C; Horattas E; Salvator A; Muakkassa K

Publisher

Journal of the American College of Surgeons

Date

2012
2012-06

Description

BACKGROUND: Our goal was to determine the need for a repeat head CT scan when the initial CT was negative. STUDY DESIGN: Data were collected from January 1, 2002 to December 31, 2008. There were 281 patients admitted to the trauma center with an initial negative head CT, who had a repeat CT during the same hospitalization. Repeat CTs were categorized into negative/negative (NNG) and negative/positive (NPG) groups. RESULTS: There were 281 patients who underwent a repeat head CT for changes in neurologic status, persistent symptoms, follow-up, decreased mental status, or suspected bleed. Of these, 241 patients remained negative (NNG) and new abnormal findings were noted in 40 patients (NPG). There were no differences in sex (NNG, 63% males vs NPG, 75% females; p = 0.14) or average age (NNG, 51.6 +/- 22.5 years vs NPG, 45.2 +/- 24.6 years; p = 0.07). There was no difference in positive toxicology (NNG, 29% vs NPG, 30%; p = 0.94) or mechanism of injury (NNG, 51% motor vehicle crash [MVC] vs NPG, 62% MVC; p = 0.18). There was a significant difference in Injury Severity Score (ISS) (NNG, 10.7 +/- 8.1 vs NPG, 17.9 +/- 11.0; p = 0.0002) and initial Glasgow Coma Scale (GCS) (NNG, 12.7 +/- 3.5 vs NPG, 10.9 +/- 4.2; p = 0.006). Patients with an ISS > 15 and who were intubated were associated with an increased odds of having a positive repeat CT scan (odds ratio [OR] 2.6; 95% CI 1.2, 5.5 and OR 3.5; 95% CI, 1.7, 7.3, respectively). CONCLUSIONS: Patients with a high ISS score and/or those who are intubated have significantly higher odds of having a positive repeat head CT when repeated for follow-up or when clinically warranted. (J Am Coll Surg 2012;214:965-972. (C) 2012 by the American College of Surgeons)

Subject

benefit; brain-injury; follow-up; intracranial injury; management; moderate; patients; serial computed-tomography; Surgery; utility

Format

Journal Article

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Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

965-972

Issue

6

Volume

214

Citation

Muakkassa F F; Marley R A; Paranjape C; Horattas E; Salvator A; Muakkassa K, “Predictors of New Findings on Repeat Head CT Scan in Blunt Trauma Patients with an Initially Negative Head CT Scan,” NEOMED Bibliography Database, accessed May 12, 2021, https://neomed.omeka.net/items/show/6584.

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