• Radiology · Mar 2013

    Head CT for nontrauma patients in the emergency department: clinical predictors of abnormal findings.

    • Xi Wang and John J You.
    • Department of Radiology, McMaster University, 1280 Main St West, Room HSC-2C8, Hamilton, ON, Canada L8S 4K1.
    • Radiology. 2013 Mar 1;266(3):783-90.

    PurposeTo identify predictors of clinically important abnormal findings in computed tomography (CT) images of the head among emergency department (ED) patients without a history of trauma.Materials And MethodsApproval was obtained from the institutional research ethics board, and informed consent from patients was not required. This study was a retrospective review of consecutive unenhanced head CT examinations in patients aged 18 years or older who did not have trauma or known intracranial pathologic processes in ED from January 2004 through June 2006. Multivariable logistic regression was used to identify predictors of clinically important abnormal CT findings in the derivation cohort (CT examinations from January 1, 2004, through August 15, 2005), and the reproducibility of findings in a validation cohort (all subsequent CT scans through to June 30, 2006) was assessed. The strength of association of each variable was expressed with clinically important abnormal CT findings as adjusted odds ratio (OR) and 95% confidence interval (CI).ResultsOf 29 469 consecutive head CT images performed at a single institution between January 1, 2004, and June 30, 2006, 3967 were eligible for this study. Of the CT images in these patients, 548 (13.8%) revealed clinically important abnormalities. Six independent clinical predictors of important abnormal findings on head CT were identified: age (adjusted OR per 10-year increase: 1.17; 95% CI: 1.08, 1.28), focal neurologic deficit (adjusted OR: 5.39; 95% CI: 3.90, 7.47), altered mental status (adjusted OR: 2.32; 95% CI: 1.66, 3.25), history of malignancy (adjusted OR: 4.11; 95% CI: 2.28, 7.42), nausea and/or vomiting (adjusted OR: 2.22; 95% CI: 1.14, 4.33), and derangements in coagulation profile (adjusted OR: 1.91; 95% CI: 1.07, 3.41).ConclusionThis study identified several potential clinical predictors of abnormal head CT findings in ED patients who did not sustain trauma. Prospective validation of a clinical prediction rule in this population is warranted.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.