Overuse of CT for Minor Head Trauma Patients: A Retrospective Analysis from Poland and Lithuania Trauma Centres

<i>Background and Objectives</i>: Head trauma is one of many conditions that trauma centres deal with daily. This study aimed to analyse the utilisation of head CT scans for patients with minor head trauma in two major hospitals in Lithuania and Poland. <i>Materials and Methods</i>: We conducted a retrospective, descriptive study of CT utilisation in minor head trauma patients presenting to the Level 1 trauma centre Hospital of the Lithuanian University of Health Sciences Kaunas Clinics (HLUHS KC) and Jan Biziel University Hospital in Bydgoszcz emergency departments (EDs), during the study period from 01 February to 30 April 2023. <i>Results</i>: During the study period, 1048 patients visited the HLUHS KC emergency department (ED) due to head trauma, and 388 patients visited the Jan Biziel University Hospital. Overall, 611 patients were included in the study. Most of the patients (92%) who suffered minimal trauma were younger than 65 years old. Eighty-two per cent of the patients older than 65 years old arrived at the ED after suffering a fall. Almost all the patients who were using antiplatelets (93%) or anticoagulants (91%) had CT scans. Non-emergency medicine (EM) physicians were more likely to order head CT scans than EM physicians (170 (83%) vs. 249 (62%), <i>p</i> < 0.001). There were 33 (5%) CT scans with traumatic features, and 8 (1%) of these were categorised as clinically significant. Patients who suffered clinically significant head trauma were more likely to be on anticoagulants and older than 65 when compared to normal/insignificant CT findings: 3 (38%) vs. 25 (6%), <i>p</i> < 0.001; and 6 (75%) vs. 146 (36%), <i>p</i> < 0.021. <i>Conclusions</i>: A significant number of head CT scans performed were not necessary according to existing head CT guidelines and risk calculators. However, even in minor head traumas, clinically significant head injuries may occur.

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Journal
Medicina
Published
2024-11-21
DOI
https://doi.org/10.3390/medicina60121908
Citations
1
Primary Topic
Traumatic Brain Injury and Neurovascular Disturbances
Type
article
Field-Weighted Citation Impact
0.37
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article

Overuse of CT for Minor Head Trauma Patients: A Retrospective Analysis from Poland and Lithuania Trauma Centres

Vytautas Aukštakalnis, Jakub Nożewski, Kristina Blažienė, Karolis Bareikis et al.
1 citations
Medicina
Traumatic Brain Injury and Neurovascular Disturbances
0.37
article

Overuse of CT for Minor Head Trauma Patients: A Retrospective Analysis from Poland and Lithuania Trauma Centres

Vytautas Aukštakalnis, Jakub Nożewski, Kristina Blažienė, Karolis Bareikis, Vaida Cibulskė, Monika Kunigonytė, Deimantė Košytė
article en
1 citations

Abstract

<i>Background and Objectives</i>: Head trauma is one of many conditions that trauma centres deal with daily. This study aimed to analyse the utilisation of head CT scans for patients with minor head trauma in two major hospitals in Lithuania and Poland. <i>Materials and Methods</i>: We conducted a retrospective, descriptive study of CT utilisation in minor head trauma patients presenting to the Level 1 trauma centre Hospital of the Lithuanian University of Health Sciences Kaunas Clinics (HLUHS KC) and Jan Biziel University Hospital in Bydgoszcz emergency departments (EDs), during the study period from 01 February to 30 April 2023. <i>Results</i>: During the study period, 1048 patients visited the HLUHS KC emergency department (ED) due to head trauma, and 388 patients visited the Jan Biziel University Hospital. Overall, 611 patients were included in the study. Most of the patients (92%) who suffered minimal trauma were younger than 65 years old. Eighty-two per cent of the patients older than 65 years old arrived at the ED after suffering a fall. Almost all the patients who were using antiplatelets (93%) or anticoagulants (91%) had CT scans. Non-emergency medicine (EM) physicians were more likely to order head CT scans than EM physicians (170 (83%) vs. 249 (62%), <i>p</i> < 0.001). There were 33 (5%) CT scans with traumatic features, and 8 (1%) of these were categorised as clinically significant. Patients who suffered clinically significant head trauma were more likely to be on anticoagulants and older than 65 when compared to normal/insignificant CT findings: 3 (38%) vs. 25 (6%), <i>p</i> < 0.001; and 6 (75%) vs. 146 (36%), <i>p</i> < 0.021. <i>Conclusions</i>: A significant number of head CT scans performed were not necessary according to existing head CT guidelines and risk calculators. However, even in minor head traumas, clinically significant head injuries may occur.

MedicinaVol. 60(12)
Lithuanian University of Health Sciences (LT), Jan Biziel University Hospital No. 2 in Bydgoszcz
Good health and well-being
Openalex Percentile: Top 33%
Traumatic Brain Injury and Neurovascular Disturbances
0.37
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