Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Inge Lehmanns Vej 6, Section 6011, DK-2100, Copenhagen, Denmark.
Department of Neurosurgery, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Sci Rep. 2022 Sep 10;12(1):15269. doi: 10.1038/s41598-022-19512-x.
Emergent brain computed tomography (CT) scan allows for identification of patients presenting with acute severe neurological symptoms in whom medical and surgical interventions may be lifesaving. The aim of this study was to evaluate if time to CT from arrival at the emergency department exceeded 30 min in patients admitted with acute severe neurological symptoms. This was a retrospective register-based quality assurance study. We identified patients admitted to the emergency department with acute severe neurological symptoms between April 1st, 2016 and September 30th, 2020. Data were retrieved from the registry of acute medical team activations. We considered that time to CT from arrival at the emergency department should not exceed 30 min in more than 10% of patients. A total of 559 patients were included. Median time from arrival at the emergency department until CT scan was 24 min (IQR 16-35) in children (< 18 years), 10 min (IQR 7-17) for adults (18-59 years), and 11 min (IQR 7-16) for elders (> 60 years). This time interval exceeded 30 min for 8.2% (95% CI 6.1-10.9) of all included patients, 35.3% of children, 5.9% of adults, and 8.6% of elders. No children died within 30 days. The 30-day mortality was 21.3% (95% CI 16.4-27) in adults, and 43.9% (95% CI 38.2-49.8) in elders. Time from arrival at our emergency department until brain CT scan exceeded 30 min in 8.2% of all included patients but exceeded the defined quality aim in children and could be improved.
急诊脑部计算机断层扫描（CT）可识别出现急性严重神经系统症状的患者，这些患者可能需要进行医学和外科干预以挽救生命。本研究旨在评估以急性严重神经系统症状入院的患者中，从到达急诊科到进行 CT 的时间是否超过 30 分钟。这是一项回顾性基于登记的质量保证研究。我们确定了 2016 年 4 月 1 日至 2020 年 9 月 30 日期间以急性严重神经系统症状入住急诊科的患者。数据取自急性医疗团队激活登记处。我们认为，在 10%以上的患者中，从到达急诊科到进行 CT 的时间不应超过 30 分钟。共纳入 559 名患者。儿童（<18 岁）从到达急诊科到进行 CT 扫描的中位数时间为 24 分钟（IQR 16-35），成人（18-59 岁）为 10 分钟（IQR 7-17），老年人（>60 岁）为 11 分钟（IQR 7-16）。这一时间间隔超过 30 分钟的患者占所有纳入患者的 8.2%（95%CI 6.1-10.9），儿童占 35.3%，成人占 5.9%，老年人占 8.6%。没有儿童在 30 天内死亡。成人的 30 天死亡率为 21.3%（95%CI 16.4-27），老年人为 43.9%（95%CI 38.2-49.8）。从到达我们的急诊科到脑部 CT 扫描的时间超过 30 分钟的患者占所有纳入患者的 8.2%，但超过了儿童的既定质量目标，可以进行改进。
