Predictors of positive CT scans in the trauma patient with minor head injury.
Predictors of positive CT scans in the trauma patient with minor head injury.
复制标题
轻微头部损伤的外伤患者 CT 扫描阳性的预测因素。
DOI：
--
复制
发表时间：
1994
期刊：
影响因子：
--
通讯作者：
R. Poelstra
中科院分区：
文献类型：
--
作者：
S. G. Moran;M. McCarthy;D. E. Uddin;R. Poelstra
对轻微头部损伤的患者进行常规脑CT扫描已被提倡作为入院的筛查程序。本研究的目的是确定是否有轻微头部损伤的创伤患者的特征。格拉斯哥昏迷评分（GCS）为13-15，这将预示着脑部CT扫描呈阳性。我们对200名被送往我们地区创伤中心的潜在头部损伤患者进行了分析。分析以下特征作为可能的预测因素：现场GCS（SC-GCS）、急诊室GCS（ER-GCS）、从现场到急诊室的GCS变化、意识丧失（EEG）和局灶性神经功能缺损。48%（96/200）的患者接受了头部CT扫描。CT扫描阳性率为4%（8/200），CT扫描阳性率为8.3%（8/96）。在没有癫痫发作且ER-GCS为13-15的患者中，所有CT扫描均为阴性（95%置信区间为0.0%至3.4%）。93例中，8例扫描阳性（P < 0.001）。在9例颅骨骨折患者中，5例CT阳性（55.6%; 95%可信区间21.2%~ 86.3%）（P < 0.0001）。在所有CT扫描阳性的患者中，有2例接受了紧急开颅手术：1例为颅骨凹陷骨折伴潜在挫伤，另1例为颞骨骨折和硬膜外血肿。两例患者的SC-GCS和ER-GCS均为15。（250字处删节）
Routine cerebral CT scanning of patients with minor head injuries has been advocated as a screening procedure for hospital admission. The purpose of this study was to determine whether there were characteristics of the trauma patient with a minor head injury. Glasgow Coma Scale (GCS) of 13-15, that would predict a positive cerebral CT scan. An analysis of 200 patients with potential head injuries transported to our regional trauma center was performed. The following characteristics were analyzed as possible predictors: scene GCS (SC-GCS), emergency room GCS (ER-GCS), a change in GCS from scene to emergency room, loss of consciousness (LOC), and focal neurological deficit. Forty-eight per cent (96/200) of the patients underwent CT scanning of the head. CT scans were positive in 4 per cent (8/200) of the total group and 8.3 per cent (8/96) of those who underwent CT scanning. In the patients without LOC and ER-GCS of 13-15, all CT scans were negative (95% confidence interval 0.0% to 3.4%). In the 93 patients with LOC, eight patients had a positive scan (P < 0.001). Of the nine patients who sustained a skull fracture, five had a positive CT (55.6%; 95% confidence interval 21.2% to 86.3%) (P < 0.0001). Of all the patients with positive CT scans, two underwent emergent craniotomy: one for a depressed skull fracture with underlying contusion, the other for a temporal bone fracture and an epidural hematoma. Both patients had LOC and SC-GCS and ER-GCS of 15.(ABSTRACT TRUNCATED AT 250 WORDS)