The use of head computed tomography in elderly patients sustaining minor head trauma.
作者： Lisa R Mack , Shu B Chan , Julio C Silva , Teresita M Hogan
DOI: 10.1016/S0736-4679(02)00714-X
关键词: Emergency department 、 Glasgow Coma Scale 、 Chi-squared distribution 、 Computed tomography 、 Retrospective cohort study 、 Central nervous system disease 、 Medicine 、 Pediatrics 、 Head injury 、 Population 、 Surgery
摘要: The study objectives were to ascertain historical and clinical criteria differentiating intracranial injury (ICI) in elderly patients with minor head trauma (MHT), determine applicability of current computed tomography (CT) scan indications this population. A 12-month retrospective chart review was performed at a community teaching hospital 34,000 annual Emergency Department (ED) visits. Included > or = 65 years old sustaining MHT Glasgow Coma Scale (GCS) score 13-15 who had CT during their stay. Data included: mechanism, symptoms, signs, GCS, anticoagulation use studies, presence alcohol drug, result, diagnosis, outcome intervention(s). There 133 patients, 19 (14.3%) suffering ICI. Four ICI required neurosurgical intervention. mean age 80.4 66% female. (21%) GCS 15, no neurologic anticoagulation. Only 1 13 signs symptoms correlated In study, useful predictors found. Current protocols based on findings may miss 30% patients. Head is recommended all MHT.
elsevier.com
sci-hub.se 参考文章(40)
Dennis G. Vollmer, James C. Torner, John A. Jane, Barbara Sadovnic, Deborah Charlebois, Howard M. Eisenberg, Mary A. Foulkes, Anthony Marmarou, Lawrence F. Marshall, Age and outcome following traumatic coma : why do older patients fare worse ? Journal of Neurosurgery. ,vol. 75, ,(1991) , 10.3171/SUP.1991.75.1S.0S37
Jan-Erik Starmark, Eddy Holmgren, Daniel Stålhammar, Current reporting of responsiveness in acute cerebral disorders. A survey of the neurosurgical literature Journal of Neurosurgery. ,vol. 69, pp. 692- 698 ,(1988) , 10.3171/JNS.1988.69.5.0692
Graham Teasdale, Bryan Jennett, ASSESSMENT OF COMA AND IMPAIRED CONSCIOUSNESS: A Practical Scale The Lancet. ,vol. 304, pp. 81- 84 ,(1974) , 10.1016/S0140-6736(74)91639-0
Ralph G. Dacey, Wayne M. Alves, Rebecca W. Rimel, H. Richard Winn, John A. Jane, Neurosurgical complications after apparently minor head injury. Assessment of risk in a series of 610 patients. Journal of Neurosurgery. ,vol. 65, pp. 203- 210 ,(1986) , 10.3171/JNS.1986.65.2.0203
Sureyya Dikmen, Joan Machamer, Nancy Temkin, Mild head injury: facts and artifacts. Journal of Clinical and Experimental Neuropsychology. ,vol. 23, pp. 729- 738 ,(2001) , 10.1076/JCEN.23.6.729.1019
Ian D. Graham, Ian G. Stiell, Andreas Laupacis, Annette M. O'Connor, George A. Wells, Emergency Physicians' Attitudes toward and Use of Clinical Decision Rules for Radiography Academic Emergency Medicine. ,vol. 5, pp. 134- 140 ,(1998) , 10.1111/J.1553-2712.1998.TB02598.X
John W. Chambers, Acute subdural haematoma. Journal of Neurosurgery. ,vol. 8, pp. 263- 268 ,(1951) , 10.3171/JNS.1951.8.3.0263
Harvey S. Levin, Steven Mattis, Ronald M. Ruff, Howard M. Eisenberg, Lawrence F. Marshall, Kamran Tabaddor, Walter M. High, Ralph F. Frankowski, Neurobehavioral outcome following minor head injury : a three-center study Journal of Neurosurgery. ,vol. 66, pp. 234- 243 ,(1987) , 10.3171/JNS.1987.66.2.0234
P. A. Gómez, R. D. Lobato, J. M. Ortega, J. de la Cruz, Mild head injury: differences in prognosis among patients with a Glasgow Coma Scale score of 13 to 15 and analysis of factors associated with abnormal CT findings. British Journal of Neurosurgery. ,vol. 10, pp. 453- 460 ,(1996) , 10.1080/02688699647078
Sherman C Stein, Steven E Ross, Minor head injury: a proposed strategy for emergency management Annals of Emergency Medicine. ,vol. 22, pp. 1193- 1196 ,(1993) , 10.1016/S0196-0644(05)80989-8