Citation

Clements TW, Dunham M, Kirkpatrick A, Rajakumar R, Gratton C, Lall R, McBeth P, Ball CG. Am. J. Surg. 2018; 215(5): 843-846.

Affiliation

Department of Surgery, University of Calgary, 1403 - 29th Street NW, Calgary, Alberta, T2N 2T9, Canada. Electronic address: ball.chad@gmail.com.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.amjsurg.2017.11.046

PMID

29336817

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.

Copyright © 2018 Elsevier Inc. All rights reserved.

Language: en

Keywords

Cognitive assessment; Computed tomography; Minor traumatic brain injury; Neurosurgery