Clinical predictors of abnormal intracranial finding in computed tomography scan in adult with mild head injury

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วัฒนชัย กุลวิวัฒน์


Most of head injury is mild head injury, Crania computed tomography (CT) is the choice for evaluating patients with mild head injury in the ED, but few shows abnormal findings. In this study aim to evaluate CT findings in patients with mild head injury and clinical symptoms to identify clinical predictors of abnormal CT scans for proper management. To identify a set of clinical finding that could be used to identify patients with mild head injury who should have abnormal intracranial finding for undergo CT brain. Retrospective cross section study of 1233 patients admitted in neurosurgery department at Hatyai Hospital for a mild head injury in the period of october 2016 to October 2017 to study predictive clinical factor which clinical related to show abnormal intracranial finding in CT scan. Using chi square Fisher, s Exact Test binary regression analysis. Our results show 8 predictive clinical factors that have the important effect on abnormal intracranial finding. Throughout the multivariate analysis, there was a clearly result indicate that only seven risk factors significantly caused the abnormal intracranial finding. Form these seven risk factors are male, headache, vomiting two times or more, suspected skull fracture, GCS13-14, fracture base of skull, dangerous mechanism especially motorcycle without helmet. These clinical predictors have significant for identifying patients with abnormal intracranial finding


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1. Bureau of Epidemiology, Department of Disease Control Ministry of public health. Severe Injury due to Transport Accident 2007. Annual Epidemiological Surveillance Report 2009; 167-181.

2. สวิง ปันจัยสีห์, นครชัย เผื่อนปฐม, กุลพัฒน์ วีรสาร, บรรณาธิการ. แนวทางเวชปฏิบัติกรณีสมองบาดเจ็บ: Clinical Practice Guidelines for Traumatic Brain Injury. 2013. [cited 2018 Mar 17].Available from:URl:

3. Af Geijerstam JL , Britton M . Mild head injury: mortality and complication ratemeta-analysis of findings in a systematic literature review. Acta Neurochir (Wien) 2003;145:843-50.

4. Haydel MJ, Preston CA, Mills TJ, Luber S, Blaudeau E, DeBlieux PM. Indications for computed tomography in patients with minor head injury. N Engl J Med 2000;343(2):100-5.

5. Stiell IG, Wells GA, Vandemheen K, Clement C, Lesiuk H, Laupacis A, et al. The Canadian CT Head Rule for patients with minor head injury. Lancet 2001;357:1391-6.

6. Af Geijerstam JL, Britton M, Marke LA. Mild head injury:observation or computed tomography? economic aspects by literaturereview and decision analysis. Emerg Med J 2004;21:54-8.

7. Af Geijerstam JL, Oredsson S, Britton M. Medical outcome after immediate computed tomography or admission for observation in patients with mild head injury:randomised controlled trial. BMJ 2006; 333:465.

8. Norlund A, Marke LA, Af Geijerstam JL, Oredsson S, Britton M. Immediate computed tomography or admission for observation after mild head injury: cost comparison in randomised controlled trial. BMJ 2006;333:469-72.

9. Yuksen C, Trainarongsakul T. Can Mild Traumatic Brain Injury risk score (MTBI risk score) predict for positive CT brain result in high risk of mild head injury patients?. Rama Med J 2013;36: 89-101.

10. Miller EC, Derlet RW, Kinser D. Minor head trauma: Is computed tomography always necessary? Ann Emerg Med 1996;27(3):290-4.

11. Smits M, Dippel DW, Steyerberg EW, de Haan GG, Dekker HM, Vos PE, et al. Predicting intracranial traumatic findings on computed tomography in patients with minor head injury: the CHIP prediction rule. Ann Intern Med 2007;146(6):397-405.

12. Stein SC, Ross SE. The value of computed tomographic scans in patients with lowrisk head injuries. Neurosurgery 1990; 26(4):638-40.

13. Miller EC, Holmes JF, Derlet RW. Utilizing clinical factors to reduce head CT scan ordering for minor head trauma patients. J Emerg Med 1997;15(4):453-7.

14. Riccardi A, Frumento F, Guiddo G, Spinola MB, Corti L, Minuto P, et al. Minor head injury in the elderly at very low risk:a retrospective study of 6 years in an Emergency Department (ED). Am J Emerg Med 2013;31(1):37-41.