Patel Rajneesh K, Choubey Amit Kumar, Soni Brijesh K, Sivasankar Rajeev, Chauhan Vikash
Department of Radiodiagnosis, Indian Naval Hospital Ship Asvini, Mumbai, Maharashtra, India.
Department of Radiodiagnosis, Indian Naval Hospital Ship Sanjivani, Kochi, Kerala, India.
J Neurosci Rural Pract. 2019 Apr-Jun;10(2):207-211. doi: 10.4103/jnrp.jnrp_362_18.
Emergency head computed tomography (CT) is rising exponentially during off working hours due to evidence-based medicine, patient's expectation and desires, easy availability and apprehension of medico-legal cases, thereby raising health-care cost. There is huge gap in demand and supply of radiologist, especially during off working hours. There is need to know the pattern of emergency head findings.
A retrospective analysis of all emergent noncontrast CT head during off working hours in the Department of Radiodiagnosis of a Tertiary Care Hospital, Mumbai, India, which were performed from June 2017 to May 2018. CT findings of 308 patients were analyzed.
About 63.6% of total head CT showed no significant abnormality. The most common abnormality was intracranial hemorrhage which was just 9.1% followed by acute infarct which was 6.2%. Extradural hemorrhage, subdural hemorrhage, and subarachnoid hemorrhage was only 1% each of total head CT findings. No significant abnormality was detected in 74.65%, 70.21%, 89.13%, 31.37%, 100%, and 69.09% in cases of head injury, seizure, giddiness/dizziness/syncope, cerebrovascular accident, transient ischemic attack, and altered sensorium, respectively.
Pattern analysis of emergent head CT reveals that most of the emergent CT head shows no significant abnormality. There is a need for stringent guidelines for emergent head CT, training of emergency physician as well as CT technician for common findings to bridge the radiologist demand-supply gap for providing effective health care in peripheral hospitals.
由于循证医学、患者的期望与诉求、获取便捷以及对医疗法律案件的担忧，非工作时间的急诊头颅计算机断层扫描（CT）数量呈指数级增长，从而增加了医疗成本。放射科医生的供需存在巨大差距，尤其是在非工作时间。有必要了解急诊头颅检查结果的模式。
对印度孟买一家三级护理医院放射诊断科2017年6月至2018年5月非工作时间进行的所有急诊非增强头颅CT进行回顾性分析。分析了308例患者的CT检查结果。
约63.6%的头颅CT显示无明显异常。最常见的异常是颅内出血，仅占9.1%，其次是急性梗死，占6.2%。硬膜外出血、硬膜下出血和蛛网膜下腔出血分别仅占头颅CT检查结果的1%。在头部受伤、癫痫发作、头晕/眩晕/晕厥、脑血管意外、短暂性脑缺血发作和意识改变的病例中，分别有74.65%、70.21%、89.13%、31.37%、100%和69.09%未检测到明显异常。
急诊头颅CT的模式分析显示，大多数急诊头颅CT无明显异常。需要制定严格的急诊头颅CT指南，培训急诊医生和CT技术人员识别常见结果，以弥合放射科医生的供需差距，从而在外围医院提供有效的医疗服务。
