Al Omran Bedoor, Patil Jayaditya Devpal, Anala Alekya, Menezes Prianna, Ahmed Noora, Cheffi Iman, Alghanem Salah
Department of Radiology, Bahrain Defence Force Hospital, Riffa, BHR.
School of Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain, Busaiteen, BHR.
Cureus. 2023 Feb 27;15(2):e35551. doi: 10.7759/cureus.35551. eCollection 2023 Feb.
The Canadian CT Head Rule (CCHR) is one of many established guidelines for assessing the need for computed tomography (CT) imaging in patients with minor head injuries. Adhering to such criteria would promote the appropriate use of CT imaging, lower healthcare expenses, and prevent harmful radiation exposure. There is no current literature assessing the overuse of CT imaging for minor head injuries in the Kingdom of Bahrain. This study aims to evaluate CT overuse in adult patients with minor head trauma. Methods: The study was conducted at the Bahrain Defense Force Hospital over 12 months from January to December 2021. All adult patients (>14 years) who sustained a minor head injury and were referred to the emergency department for CT brain imaging were included in the study. Patients presenting for other reasons or suffering from moderate to severe head injuries were excluded. CT reports were retrieved for analysis. The CCHR was used as a reference. Results: A total of 486 CT scans were performed. Loss of consciousness was the most common symptom on presentation (n = 74 cases). Only 12.1% of CT scans reported positive findings. The prevalence of CT overuse was highest in patients aged 21-30 years. Patients presenting with loss of consciousness showed a high overuse of CT imaging, accounting for 20.3% of all cases. Only 77.4% of cases met the CCHR criteria and 22.6% were defined as overuse, with 95% confidence interval (0.189, 0.266). Conclusion: When referring to the CCHR, CT imaging for a minor head injury in adults was overused in 22.6% of cases. Further research will be required to reveal the underlying reasons for these findings along with interventions to reduce future overuse.
加拿大头部CT规则（CCHR）是众多已确立的用于评估轻度头部受伤患者是否需要进行计算机断层扫描（CT）成像的指南之一。遵循此类标准将促进CT成像的合理使用，降低医疗费用，并防止有害辐射暴露。目前尚无文献评估巴林王国轻度头部受伤患者CT成像的过度使用情况。本研究旨在评估成年轻度头部外伤患者的CT过度使用情况。方法：该研究于2021年1月至12月在巴林国防军医院进行了12个月。所有成年患者（>14岁）若遭受轻度头部损伤并被转诊至急诊科进行脑部CT成像均纳入本研究。因其他原因就诊或患有中度至重度头部损伤的患者被排除。检索CT报告进行分析。以CCHR作为参考。结果：共进行了486次CT扫描。意识丧失是就诊时最常见的症状（n = 74例）。仅12.1%的CT扫描报告有阳性结果。CT过度使用的发生率在21 - 30岁患者中最高。出现意识丧失的患者CT成像过度使用情况较高，占所有病例的20.3%。仅77.4%的病例符合CCHR标准，22.6%被定义为过度使用，95%置信区间为（0.189，0.266）。结论：参照CCHR，22.6%的成年轻度头部受伤患者的CT成像存在过度使用情况。需要进一步研究以揭示这些结果的潜在原因以及减少未来过度使用的干预措施。
