Adherence to a clinical decision policy for head computed tomography in adult mild traumatic brain injury

• Published in: The American journal of emergency medicine Vol. 33; no. 2; pp. 299 - 300
• Main Authors: Marin, Jennifer R., MD, MSc, Shofer, Frances S., PhD, Chang, Ivy, BA, Mills, Angela M., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2015; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Brain Injuries - diagnostic imaging; Computed tomography; Confidence intervals; Emergency; Emergency medical care; Emergency Service, Hospital - statistics & numerical data; Female; Guideline Adherence - statistics & numerical data; Head injuries; Humans; Male; Medical imaging; Middle Aged; Neuroimaging - utilization; Physicians; Practice Guidelines as Topic; Retrospective Studies; Tomography; Tomography, X-Ray Computed - utilization; Trauma; Traumatic brain injury; Young Adult
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2014.11.017

[...]this study was within a single health system, and, therefore, the data may not generalize across all settings. Characteristic n (%) Sex, male 400 (52.8) Age (y), median (range) 43 (18-101) Race/ethnicity  Black, non-Hispanic 425 (56.1) White, non-Hispanic 245 (32.3) Other 65 (8.6) Missing 23 (3.0) Primary insurance  Private 211 (30.9) Medicare 178 (26.1) Medicaid 145 (21.3) Self-pay 148 (21.7) Missing 76 (10.0) Triage level (ESI)a  1 1 (0.13) 2 117 (15.4) 3 462 (60.1) 4 172 (22.7) 5 6 (0.79) Discharged  Clinical signs/symptomsb 634 (83.6) Loss of consciousness 177 (23.4) Amnesia 72 (9.5) Headache 418 (55.2) Emesis 18 (2.4) Age >60 years 206 (27.2) Drug or alcohol intoxication 109 (14.4) Short-term memory deficits 17 (2.2) Trauma above the clavicle 536 (70.7) Posttraumatic seizure 4 (0.5) GCS, <15 30 (4) Focal neurologic deficit 17 (2.2) Coagulopathy 52 (6.9) Severe headachec 8 (1) Age >=65 years 179 (23.6) Signs of basilar skull fracture 0 (0) Dangerous mechanism of injuryd 42 (5.5) Table Characteristics of visits for mild TBI (n = 758)