The application of North American CT scan criteria to an Australian population with minor head injury

Brown, Anthony F. T., Chu, Kevin, Rosengren, David and Rothwell, Sean (2004) The application of North American CT scan criteria to an Australian population with minor head injury. Emergency Medicine Australasia, 16 3: 195-200. doi:10.1111/j.1742-6723.2004.00563.x


Author Brown, Anthony F. T.
Chu, Kevin
Rosengren, David
Rothwell, Sean
Title The application of North American CT scan criteria to an Australian population with minor head injury
Journal name Emergency Medicine Australasia   Check publisher's open access policy
ISSN 1442-2026
1742-6731
1742-6723
Publication date 2004-06-01
Sub-type Article (original research)
DOI 10.1111/j.1742-6723.2004.00563.x
Open Access Status
Volume 16
Issue 3
Start page 195
End page 200
Total pages 6
Place of publication Carlton, Vic, Australia
Publisher Blackwell Science
Language eng
Subject 110305 Emergency Medicine
Formatted abstract
Objective:
To determine potential changes in the number of CT head scans performed if the New Orleans Criteria (NOC) or Canadian CT Head Rule (CCTR) was applied to an Australian emergency department population of minor head injured (MHI) patients.

Methods:

A retrospective chart review was conducted in an adult metropolitan teaching hospital in Brisbane. All patients presenting over a 3-month period with a GCS Score of 15 following an MHI and had a CT head scan performed were selected for analysis. Using clinically significant CT abnormalities and neurological intervention as the outcome measures, the NOC and CCTR were applied to determine if CT scanning was considered necessary.

Results:
Of the 240 patients reviewed, 230 had a normal CT scan and 10 had clinically significant CT abnormalities. One patient with CT abnormality required neurosurgical intervention. Application of the NOC would have resulted in a 3.8% (95% CI 1.7–7.0%) reduction in CT scans performed without missing any patients with CT abnormalities or requiring neurological intervention. Application of the CCTR using both high and low risk factors would have resulted in a 46.7% (95% CI 40.2–53.2%) reduction in CT scans performed without missing the patient requiring neurological intervention, but would not have detected two patients with clinically significant CT abnormalities.

Conclusion:
Neither the NOC nor the CCRT appear suitable for significantly reducing the number of normal CT head scans performed without missing clinically significant CT abnormalities when applied to our current clinical practice.
Keyword Decision making
Head Injury
Minor
Tomography scanners
X-ray computed
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Tue, 31 Mar 2009, 22:56:58 EST by Juliette Grosvenor on behalf of Medicine - Royal Brisbane and Women's Hospital