Department of Radiology, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Department of Radiology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Emerg Radiol. 2021 Apr;28(2):251-257. doi: 10.1007/s10140-020-01846-6. Epub 2020 Aug 25.
CT scan is crucial in evaluating head trauma. However, its inappropriate use will cause unnecessary radiation exposure to patient and financial burden to health systems. Our aim is appraising amount of brain CT scans performed in our Emergency Department (ED) for evaluating mild head trauma which are not indicated according to four standardized guidelines as well as analyzing contributing factors.
This was a descriptive prospective study. We included randomly selected adult patients under 75 years old with minor head trauma evaluated by brain CT scan at our ED. For all patients, we completed a checklist including demographic data, mechanism of trauma, specialty of the requesting physician, and whether the patient meets the brain CT guidelines criteria. Brain CT overuse was defined as scans performed for patients without criteria of any of the standardized guidelines.
We evaluated 170 patients. The mean age of patients was 38.38 ± 19.73 years old. The most common mechanism of trauma was falling (37.6%). The overall brain CT scan overuse was 15.3%. Most of the overused scans were performed in younger patients, and patient's age was inversely correlated to overuse. There was no significant difference based on the mechanism of trauma and the specialty of requesting physician.
Our study accentuates the high frequency of brain CT scan overuse, leading to unnecessary radiation exposure and financial burden on healthcare systems. We emphasize that using a guideline for requesting brain CT scan can eliminate unnecessary scans along with detecting patients with important decisive damages.
CT 扫描在评估头部创伤中至关重要。然而，不恰当地使用它会给患者带来不必要的辐射暴露，并给医疗系统带来经济负担。我们的目的是评估我们急诊部（ED）中进行的用于评估轻度头部创伤的脑 CT 扫描量，这些扫描不符合四项标准化指南，同时分析促成因素。
这是一项描述性前瞻性研究。我们纳入了在我们的 ED 接受脑 CT 扫描评估轻度头部创伤的随机选择的 75 岁以下成年患者。对于所有患者，我们填写了一份检查表，其中包括人口统计学数据、创伤机制、请求医生的专业以及患者是否符合脑 CT 指南标准。脑 CT 过度使用被定义为对不符合任何标准化指南标准的患者进行的扫描。
我们评估了 170 名患者。患者的平均年龄为 38.38±19.73 岁。最常见的创伤机制是跌倒（37.6%）。总体脑 CT 扫描过度使用率为 15.3%。大多数过度使用的扫描是在年轻患者中进行的，患者年龄与过度使用呈反比。根据创伤机制和请求医生的专业，没有显著差异。
我们的研究强调了脑 CT 扫描过度使用的高频率，导致患者不必要的辐射暴露和医疗系统的经济负担。我们强调，使用脑 CT 扫描请求指南可以消除不必要的扫描，同时检测到具有重要决定性损伤的患者。
