Clinical efficacy of serial computed tomographic scanning in severe closed head injury patients

J Trauma. 2003 Dec;55(6):1061-4. doi: 10.1097/01.TA.0000096712.90133.5C.

Abstract

Background: The purpose of this study was to determine whether serial computed tomographic (CT) scans of the head serve to prompt operative intervention. After the initial and 24- to 48-hour repeat scans, if no operative intervention has been performed, further serial scans are ordered on a planned basis or on the basis of changes in clinical status.

Methods: This study is a retrospective review from January 1996 to December 2000. Results of the initial, follow-up, and serial CT scans were recorded for the 51 patients who met the inclusion/exclusion criteria.

Results: One hundred seventeen (53.4%) serial CT scans were ordered. No urgent operative interventions were performed on the basis of the serial CT scans. Three scans (2.56%) led to nonurgent neurosurgical intervention.

Conclusion: In severe head-injured patients who are nonneurosurgical candidates on the basis of initial and repeat CT scans, serial head CT scans have little clinical efficacy and do not lead to urgent operative intervention.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Aftercare / economics
  • Aftercare / methods
  • Aftercare / standards
  • Emergencies / epidemiology
  • Female
  • Glasgow Coma Scale
  • Head Injuries, Closed / diagnostic imaging*
  • Head Injuries, Closed / economics
  • Head Injuries, Closed / etiology
  • Head Injuries, Closed / surgery
  • Hospital Costs / statistics & numerical data
  • Humans
  • Injury Severity Score
  • Intracranial Pressure
  • Length of Stay
  • Male
  • Michigan / epidemiology
  • Middle Aged
  • Monitoring, Physiologic
  • Neurosurgical Procedures / statistics & numerical data
  • Patient Selection
  • Predictive Value of Tests
  • Retrospective Studies
  • Time Factors
  • Tomography, X-Ray Computed / economics
  • Tomography, X-Ray Computed / methods*
  • Tomography, X-Ray Computed / standards