Pan-body computed tomographic scanning for patients with intracranial hemorrhage after low-energy falls

Abstract Background We sought to determine if a liberal policy of pan-body computerized tomography (CT) scanning was useful in patients with intracranial hemorrhage after low falls. Methods Patients with intracranial hemorrhage after low falls, with a Glasgow Coma Score of greater than or equal to 1...

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Bibliographic Details
Published in:The American journal of surgery 2015-03, Vol.209 (3), p.521-525
Main Authors: Ong, Adrian W., M.D, Castor, Laura, P.A.C, Figueredo, Ronald, M.D, Butler, Susan, R.N, Fernandez, Forrest, M.D
Format: Article
Language:English
Subjects:
Accidental Falls
Aged
Anticoagulants
Blood pressure
Brain Injuries - complications
Brain Injuries - diagnostic imaging
Cardiac arrhythmia
Coma
Computerized tomography
Confidence intervals
Diagnosis, Differential
Emergency medical care
Falls
Female
Follow-Up Studies
Fractures
Humans
Intracranial Hemorrhages - diagnostic imaging
Intracranial Hemorrhages - etiology
Male
Medical imaging
Reproducibility of Results
Retrospective Studies
Surgery
Tomography, X-Ray Computed - methods
Trauma Centers
Trauma Severity Indices
Traumatic intracranial hemorrhage
Variables
Whole Body Imaging - methods
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Summary:Abstract Background We sought to determine if a liberal policy of pan-body computerized tomography (CT) scanning was useful in patients with intracranial hemorrhage after low falls. Methods Patients with intracranial hemorrhage after low falls, with a Glasgow Coma Score of greater than or equal to 14 and systolic blood pressure of greater than 100 mm Hg, were included. The primary outcome was any torso or spine injury requiring surgical or radiologic intervention. The secondary outcome was any torso or spine injury. Results Of 365 patients, 71% underwent pan-body CT. Eight (2%) patients had a primary outcome and 66 (18%) a secondary outcome. Only signs and symptoms of cervical injury were associated with a cervical-related outcome (4/23 vs 3/316, P = .005). Only signs and symptoms of torso injury were associated with a torso-related outcome. Conclusions A liberal policy of pan-body CT in these patients is of low yield. Signs and symptoms of trauma should dictate the judicious use of CT.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2014.12.002