How necessary is the computerized brain tomography in minor head trauma?

Abstract

BACKGROUND: Head trauma is a health problem that may be observed in all age groups, and it may cause significant losses in terms of health and economy. The purpose of our study is to evaluate the abnormal computerized brain tomography (CBT) prevalence and the rate of admission to brain surgery clinics in patients who applied to the Emergency Service Department for CBT due to minor head trauma. METHODS: In the present study, the patients who were admitted to Afyonkarahisar Health Sciences University, Faculty of Medicine Hospital, Emergency Service Department between January 1st, 2017, and December 31st, 2017, due to head trauma and in who CBT was performed were examined retrospectively. The electronic files, CBTs, and consultation notes of these patients were accessed in the information system of the hospital. RESULTS: A total of 43,389 patients who applied to the Emergency Service Department in 1 years’ time (2017) were examined retrospectively. As a result of the examination, it was determined that a total of 2,515 (5.7%) patients received CBT. The reason for a total of 1,152 (45%) of these patients was traumatic injury. It was determined that 618 (53.6%) of the patients in who CBT was performed due to trauma were aged <18 years; 280 (24.3%) patients were aged <2 years; 179 (15.5%) patients had to consult with the Brain Surgery Clinic; and 94 (8.1%) were hospitalized. It was also determined that there were abnormal computed tomography (CT) findings in only 68 (5.9%) of the patients in who CBT was performed. CONCLUSION: The use of CBT indication criteria, which have been previously established and which reliability has been proven, in emergency trauma cases applying to the Emergency Service Department with minor head traumas may reduce the complication risk that may appear as a result of an unnecessary CBT and avoid complications that may occur in the long run due to CBT.

AMAÇ: Kafa travmaları tüm yaş gruplarında görülebilen, sağlık ve ekonomi açısından önemli kayıplara neden olabilen bir sağlık sorunudur. Çalışmamızın amacı, acil servise minör kafa travması nedeniyle başvuran ve bilgisayarlı beyin tomografisi (BBT) çekilen hastalarda, anormal BBT prevalansını ve beyin cerrahi kliniğine yatış oranlarını değerlendirmektir. GEREÇ VE YÖNTEM: Çalışmada Afyonkarahisar Sağlık Bilimleri Üniversitesi Tıp Fakültesi Hastanesi Acil Servisi’ne 01.01.2017–31.12.2017 tarihleri arasında kafa travması nedeniyle gelen ve BBT çekilen hastalar geriye dönük olarak incelendi. Hastane bilgi sisteminden bu hastaların elektronik dosyalarına, BBT’lerine ve konsültasyon notlarına ulaşıldı. BULGULAR: Bir yıllık (2017) süre içerisinde acil servise başvuru yapan 43.389 hastaya ulaşıldı. İnceleme sonucunda 2515 (%5.7) hastaya BBT çekildiği saptandı. Bu hastaların 1152’sinin (%45) başvuru nedeni travma idi. Travmaya bağlı olarak BBT çekilen 618 (%53.6) hastanın 18 yaş altı olduğu, 280 (%24.3) hastanın iki yaş altı olduğu, 179 (%15.5) hastanın beyin cerrahisi kliniği ile konsülte edildiği ve 94 (%8.1) hastaya yatış verildiği saptandı. BBT çekilen sadece 68 (%5.9) hastada anormal BT bulguları saptandı. TARTIŞMA: Acil servise minör kafa travması ile gelenlerde, daha önce tespit edilen ve güvenilirliği kanıtlanan BBT çekim endikasyon kriterlerinin kullanılması, düşük riskli hastaların takip edilmesi, gereksiz BBT çekimlerini ve çekime bağlı uzun dönemde gelişebilecek komplikasyonları azaltabilir.