Sinclair D E, Kovacs G, Hillis M
Department of Emergency Medicine, Victoria General Hospital, Halifax, Nova Scotia, Canada.
J Emerg Med. 1993 Sep-Oct;11(5):643-6. doi: 10.1016/0736-4679(93)90325-2.
The purpose of this retrospective review was to determine high-yield criteria for the ordering of cranial computed tomography (CT scans) in the emergency department. All patients (n = 416) presenting to an adult tertiary care Emergency Department over a 1-year period who required an emergency CT scan were studied. The indications for the scan and the rate of abnormal results were headache (26%), seizures (17%), focal weakness (46%), acute trauma (37%), late trauma (22%), altered mental status (32%), coma (54%), and other (32%). The overall rate of abnormal scans was 39%. In conclusion, the current clinical practice of ordering cranial CT scans on an emergency basis seems to produce an acceptable level of "abnormal" results. Additional prospective studies are required to further define high-yield criteria and measure the impact of the "negative" scan on patient management.
这项回顾性研究的目的是确定在急诊科开具颅脑计算机断层扫描（CT扫描）的高收益标准。对在1年期间到一家成人三级护理急诊科就诊且需要进行急诊CT扫描的所有患者（n = 416）进行了研究。扫描的指征及异常结果的发生率分别为：头痛（26%）、癫痫发作（17%）、局灶性无力（46%）、急性创伤（37%）、晚期创伤（22%）、精神状态改变（32%）、昏迷（54%）以及其他（32%）。扫描结果异常的总体发生率为39%。总之，目前在急诊情况下开具颅脑CT扫描的临床实践似乎产生了可接受水平的“异常”结果。需要进一步开展前瞻性研究以进一步明确高收益标准，并衡量“阴性”扫描对患者管理的影响。
