Factor associated with non-contrast Computed Tomography scan of the brain in patients with altered mental status at Accident and Emergency Department, Chiangrai Prachanukroh hospital
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Abstract
Background Altered mental status is a common emergency condition frequently encountered in the Accident and Emergency Department. Symptoms can range from confusion to coma, if improperly diagnosed, can lead to death or disability. The cause may be abnormalities from brain pathology or other factors. Non-contrast CT brain is an important tool for quickly identifying abnormalities within the brain.ส่วนบนของฟอร์มส่วนล่างของฟอร์ม
Objective To identify factors associated with abnormal non-contrast CT brain and to determine the possible abnormalities in non-contrast CT brain in patients present with altered mental status at the Accident and Emergency Department, Chiangrai Prachanukroh Hospital
Methods This study was retrospective in the sample visited from January 1, 2020, to December 31, 2022. A multivariable logistic regression exploratory model was employed to determine factors contributing to abnormal non-contrast CT brain findings, expressed as odds ratios with 95%CI.
Results Among 515 patients with altered mental status, 144 exhibited abnormal findings on non-contrast CT brain. The study revealed that patients presented with a focal neurological deficit (mOR 38.22, 95% CI: 19.39-75.37, p-value <0.001), history of extra-CNS malignancy (mOR 4.34, 95%CI: 1.40-13.42, p-value 0.011), headache (mOR 3.98, 95%CI: 1.69-9.34, p-value 0.002), seizure (mOR 2.52, 95%CI: 1.13-5.60, p-value 0.024), transient loss of consciousness (mOR 2.44, 95%CI: 1.12-5.30, p-value 0.024) and nausea vomiting (mOR 2.26, 95%CI: 1.04-4.89, p-value 0.038) were significantly associated with abnormal non-contrast CT brain finding. The most common abnormal finding was intracerebral hemorrhage (31.25%).
Conclusions and recommendations Patients with altered mental status who presented with focal neurological deficits, a history of extra-CNS malignancy, headaches, seizures, transient loss of consciousness, and nausea and vomiting should undergo non-contrast CT brain finding.
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