Ingebrigtsen T, Romner B
Department of Neurosurgery, University Hospital of Tromsø, Norway.
Acta Neurol Scand. 1996 Feb-Mar;93(2-3):207-10. doi: 10.1111/j.1600-0404.1996.tb00201.x.
Significant hospital resources are invested in early detection of intracranial complications after minor head injuries (MHI). This study focuses on economic aspects of MHI management. 88 MHI patients underwent routine early CT-scan and at least 24 h in-hospital observation. The cost of this management was calculated, and compared to estimated costs of three alternative management protocols. CT-scans demonstrated intracranial lesions in eight (9%) patients, but none required neurosurgical intervention. The expense of our management was Norwegian Kroner (NOK) 576,136. An alternative management protocol including routing early CT-scan and discharge of patients with normal CT-findings, Glasgow coma score > or = 14 and no neurological deficits, was found to be safe, and estimated to reduce costs with 43% to NOK 326,669. It is concluded that routine early CT-scan is the most reliable and cost saving management procedure after MHI.
医院投入了大量资源用于早期发现轻度头部损伤(MHI)后的颅内并发症。本研究聚焦于MHI管理的经济方面。88例MHI患者接受了常规早期CT扫描并在医院至少观察24小时。计算了这种管理方式的成本,并与三种替代管理方案的估计成本进行了比较。CT扫描显示8例(9%)患者存在颅内病变,但无一例需要神经外科干预。我们这种管理方式的费用为576,136挪威克朗(NOK)。一种替代管理方案包括常规早期CT扫描以及对CT检查结果正常、格拉斯哥昏迷评分≥14且无神经功能缺损的患者予以出院,结果发现该方案是安全的,且估计可将成本降低43%至326,669挪威克朗。结论是,常规早期CT扫描是MHI后最可靠且最节省成本的管理程序。