Neurocognitive assessment in patients with a minor traumatic brain injury and an abnormal initial CT scan: Can cognitive evaluation assist in identifying patients who require surveillance CT brain imaging? - 25/04/18
, Michael Dunham , Andrew Kirkpatrick , Ruphus Rajakumar , Carolyn Gratton , Rohan Lall , Paul McBeth , Chad G. Ball ⁎ Abstract |
Background |
Evidence for repeat computed tomography (CT) in minor traumatic brain injury (mTBI) patients with intracranial pathology is scarce. The aim of this study was to investigate the utility of clinical cognitive assessment (COG) in defining the need for repeat imaging.
Methods |
COG performance was compared with findings on subsequent CT, and need for neurosurgery in mTBI patients (GCS 13–15 and positive CT findings).
Results |
Of 152 patients, 65.8% received a COG (53.0% passed). Patients with passed COG underwent fewer repeat CT (43.4% vs. 78.7%; p = .001) and had shorter LOS (8.7 vs. 19.5; p < .05). Only 1 patient required neurosurgery after a passed COG. The negative predictive value of a normal COG was 90.6% (95%CI = 81.8%–95.4%).
Conclusion |
mTBI patients with an abnormal index CT who pass COG are less likely to undergo repeat CT head, and rarely require neurosurgery. The COG warrants further investigation to determine its role in omitting repeat head CT.
Le texte complet de cet article est disponible en PDF.Highlights |
• | A cognitive assessment's negative predictive value is 90.6% for worsening CT head. |
• | Patients who pass a cognitive assessment are at low risk of requiring neurosurgery. |
• | Patients who pass a cognitive assessment have a shorter hospital length of stay. |
• | The cognitive assessment warrants further study in mild TBI. |
Keywords : Cognitive assessment, Minor traumatic brain injury, Computed tomography, Neurosurgery
Plan
Vol 215 - N° 5
P. 843-846 - mai 2018 Retour au numéro
Article précédent
- Discussion of “Nonatherosclerotic vascular causes of acute abdominal pain”
- James P. Dolan
- Discussion of “Neurocognitive assessment in patients with a minor traumatic brain injury and an abnormal initial CT scan: Can cognitive evaluation assist in identifying patients who require surveillance CT brain imaging?”
- Matthew J. Martin
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