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减少轻度创伤性脑损伤中不必要的头部计算机断层扫描

Reducing Unnecessary Head Computed Tomography in Mild Traumatic Brain Injury.

作者信息

Webster Nathaniel John, Moore Nathan, Stewart Felicia

机构信息

Medical Associates, LLP, Emergency Department, Community Health Network, Indianapolis, Indiana (Mr Webster); Gulf Coast Internists, Palm Harbor, Florida (Mr Moore); and Advanced Practice Nursing Dept, Indiana State University, Terre Haute (Dr Stewart).

出版信息

Adv Emerg Nurs J. 2017 Oct/Dec;39(4):300-308. doi: 10.1097/TME.0000000000000169.

Abstract

There is growing concern about the frequency of computed tomographic (CT) scans performed for evaluation of adults with suspected mild traumatic brain injury. The Canadian CT Head Rule and the New Orleans Criteria are the most studied head CT decision tools that aid providers in determining which patients do not require a CT scan. This article examines recent research to determine which of these tools has proven to be the most effective at safely reducing the use of head CT scans. The reviewed studies concluded that both the Canadian CT Head Rule and the New Orleans Criteria had similar sensitivities, but the Canadian CT Head Rule showed superior specificity in predicting the presence of a clinically significant brain injury. The authors of this article recommend that the Canadian CT Head Rule be used in the evaluation of minor head injury to reduce unnecessary CT scans.

摘要

对于为疑似轻度创伤性脑损伤的成年人进行计算机断层扫描(CT)的频率,人们越来越担忧。加拿大CT头部规则和新奥尔良标准是研究最多的头部CT决策工具,可帮助医疗人员确定哪些患者不需要进行CT扫描。本文研究了近期的相关研究,以确定这些工具中哪一种在安全减少头部CT扫描使用方面已被证明是最有效的。经审查的研究得出结论,加拿大CT头部规则和新奥尔良标准具有相似的敏感性,但在预测临床上有意义的脑损伤方面,加拿大CT头部规则显示出更高的特异性。本文作者建议在评估轻度头部损伤时使用加拿大CT头部规则,以减少不必要的CT扫描。

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