The aims was to assess the amount of computed tomography (CT) scans for minor head injury (MHI) performed in young patients in our emergency department (ED), not indicated by National Institute for Health and Clinical Excellence (NICE) and Canadian Computed Tomography Head Rules (CCHR), and to analyze factors contributing to unnecessary examinations. Secondary objectives were to calculate the effective dose, to establish the number of positive CT and to analyze which of the risk factors are correlated with positivity at CT; finally, to calculate sensitivity...
Description of activity and work performed
Materials and methods:
We retrospectively evaluated 493 CT scans of patients aged 18–45years, collecting the following parameters from ED medical records: patient demographics, risk factors indicating the need of brain imaging, trauma mechanism, specialty and seniority of the referring physician. For each CT, the effective dose and the negativity/positivity were assessed.
357/493 (72%) and 347/493 (70%) examinations were not in line with the CCHR and NICE guidelines, respectively.
No statistically significant difference between physician specialty (p = 0.29 for CCHR; p = 0.24 for...
Conclusion and recommendations
We observed an important overuse of head CT scans in MHI; the main promoting factor for inappropriate was injury mechanism. 2% of head CT were positive, correlating with signs of suspected skull fracture and motor vehicle accident with high energy impact.
G. Clesceri; Palermo/IT - nothing to disclose G. Lo Re; Palermo/IT - nothing to disclose M. C. Terranova; Palermo/IT - nothing to disclose M. T. Anzelmo; Palermo/IT - nothing to disclose A. Crapanzano; Palermo/IT - nothing to disclose S. Salerno; Palermo/IT - nothing to disclose T. V. Bartolotta; Palermo/IT - nothing to disclose
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