Necessity of monitoring after negative head CT in acute head injury

Harri Isokuortti, Teemu M. Luoto, Anneli Kataja, Antti Brander, Jari Siironen, Suvi Liimatainen, Grant L. Iverson, Aarne Ylinen, Juha Öhman

Research output: Contribution to journalArticleScientificpeer-review

5 Citations (Scopus)

Abstract

Objective The main objective of this study was to evaluate the incidence of delayed complications in acute head injury (HI) patients with an initial normal head computed tomography (CT). Materials and methods This retrospective study included 3023 consecutive patients who underwent head CT due to an acute HI at the Emergency Department (ED) of Tampere University Hospital (August 2010-July 2012). Regardless of clinical injury severity, the patients with a normal head CT were selected (n = 2444, 80.9%). The medical records of these patients were reviewed to identify the individuals with a serious clinically significant complication related to the primary HI. The time window considered was the following 72 h after the primary head CT. A repeated head CT in the hospital ward, death, or return to the ED were indicative of a possible complication. Results The majority (n = 1811, 74.1%) of the patients with a negative head CT were discharged home and 1.1% (n = 27) of these patients returned to ED within 72 h post-CT. A repeated head CT was performed on 12 (44.4%) of the returned patients and none of the scans revealed an acute lesion. Of the 632 (25.9%) CT-negative patients admitted to the hospital ward from the ED, a head CT was repeated in 46 (7.3%) patients within 72 h as part of routine practice. In the repeated CT sample, only one (0.2%) patient had a traumatic intracranial lesion. This lesion did not need neurosurgical intervention. The overall complication rate was 0.04%. Conclusion In the present study, which includes head injuries of all severity, the probability of delayed life-threatening complications was negligible when the primary CT scan revealed no acute traumatic lesions.

Original languageEnglish
Pages (from-to)1340-1344
Number of pages5
JournalInjury
Volume45
Issue number9
DOIs
Publication statusPublished - 2014
Publication typeA1 Journal article-refereed

Keywords

  • Computed tomography
  • Head injury
  • Hospital discharge
  • Mortality
  • Traumatic brain injury

Publication forum classification

  • Publication forum level 1

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