Ansab A Haider1, Peter Rhee1, Tahereh Orouji1, Narong Kulvatunyou1, Tania Hassanzadeh1, Andrew Tang1, Adil Farman1, Terence O'Keeffe1, Rifat Latifi1, Bellal Joseph2. 1. Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, 501 North Campbell Avenue, Room 5411, PO Box 245063, Tucson, AZ, 85724, USA. 2. Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, 501 North Campbell Avenue, Room 5411, PO Box 245063, Tucson, AZ, 85724, USA. Electronic address: bjoseph@surgery.arizona.edu.
Abstract
BACKGROUND: The practice of a routine repeat head computed tomographic scans in patients with traumatic brain injury (TBI) is under question. The aim of our study was to evaluate the utility of a more than 1 repeat head computed tomography (M1CT) scans in patients with TBI. METHODS: We performed a 3-year analysis of a prospectively collected database of all TBI patients presenting to our level I trauma center. Patients who received M1CT scans were included. Findings and reason (without neurologic decline vs after neurologic decline) for M1CT were recorded. Primary outcome measure was neurosurgical intervention. RESULTS: A total of 296 patients that underwent M1CT were included. Of those, 291 patients (98.6%) had M1CT without a neurologic decline, and neurosurgical intervention was performed in 1 patient (.3%) who was inexaminable (Glasgow coma scale score = 6). The remaining (n = 5) had M1CT due to a neurologic decline; 4 patients (80%) of the 5 had worsening of ICH; and neurosurgical intervention was performed in 3 (75%) of the 4 patients. CONCLUSIONS: The practice of multiple repeat head computed tomographic scans should be limited to inexaminable patients or patients with neurological deterioration.
BACKGROUND: The practice of a routine repeat head computed tomographic scans in patients with traumatic brain injury (TBI) is under question. The aim of our study was to evaluate the utility of a more than 1 repeat head computed tomography (M1CT) scans in patients with TBI. METHODS: We performed a 3-year analysis of a prospectively collected database of all TBIpatients presenting to our level I trauma center. Patients who received M1CT scans were included. Findings and reason (without neurologic decline vs after neurologic decline) for M1CT were recorded. Primary outcome measure was neurosurgical intervention. RESULTS: A total of 296 patients that underwent M1CT were included. Of those, 291 patients (98.6%) had M1CT without a neurologic decline, and neurosurgical intervention was performed in 1 patient (.3%) who was inexaminable (Glasgow coma scale score = 6). The remaining (n = 5) had M1CT due to a neurologic decline; 4 patients (80%) of the 5 had worsening of ICH; and neurosurgical intervention was performed in 3 (75%) of the 4 patients. CONCLUSIONS: The practice of multiple repeat head computed tomographic scans should be limited to inexaminable patients or patients with neurological deterioration.
Authors: Fabio Holanda Lacerda; Hassan Rahhal; Leonardo Jorge Soares; Francisco Del Rosario Matos Ureña; Marcelo Park Journal: Rev Bras Ter Intensiva Date: 2017 Apr-Jun