TY  - JOUR
PY  - 2020//
TI  - Does the evidence justify routine transfer of residents of aged care facilities for CT scan after minor head trauma?
JO  - Internal medicine journal
A1  - Green, Lorne
A1  - Selleck, Lucy
A1  - Gibbons, Michael
A1  - Klim, Sharon
A1  - Ritchie, Peter
A1  - Patel, Rajesh
A1  - Pham, Chris
A1  - Kelly, Anne-Maree
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: In 2014, the South Australian coroner recommended that residents of aged care facilities (RACF) who had sustained a head injury should be transported to emergency departments (ED) for assessment and a head CT scan, with the view to preventing mortality. The evidence base for the recommendation is unclear.The aim of this study was to determine the rate of emergent intervention (neurosurgery, transfusion of blood products or reversal of anticoagulation) in residents transferred to ED with minor head trauma who had their usual cognitive function on ED assessment. <br><br>METHODS: This was a retrospective cohort study by medical records review at two university-affiliated community ED. Participants were patients from RACF attending ED who had suffered minor head trauma and had their usual cognitive function. Exclusions were altered conscious state, new neurological findings or associated orthopaedic injury requiring hospital admission. The primary outcome was rate of emergent intervention in residents transferred to ED with minor head truama who had their usual cognitive function on ED assessment. <br><br>RESULTS: 366 patients were studied; median age 86, 45% taking anticoagulant/antiplatelet medication. 80% underwent head CT. 6% had ICH (95% CI 4-8.9%). No patient underwent neurosurgery. One had emergent intervention, reversal of anticoagulation (0.3%, 95% CI 0.05-1.5%). <br><br>CONCLUSION: The rate of emergent intervention for ICH in patients from RACF who sustained a minor head trauma but had their normal cognitive function was <1%. None underwent neurosurgical intervention. The low rate of intervention seriously challenges the appropriateness of routine transfer and CT for this patient group. This article is protected by copyright. All rights reserved.<br><br>This article is protected by copyright. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 1444-0903
UR  - http://dx.doi.org/10.1111/imj.14808
ID  - ref1
ER  -