Adherence to a clinical decision policy for head computed tomography in adult mild traumatic brain injury
[...]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 (...
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| Published in: | The American journal of emergency medicine Vol. 33; no. 2; pp. 299 - 300 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
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| Abstract | [...]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) |
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| AbstractList | [...]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) |
| Author | Marin, Jennifer R., MD, MSc Mills, Angela M., MD Chang, Ivy, BA Shofer, Frances S., PhD |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25481341$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1016/j.annemergmed.2011.05.020 10.1016/j.annemergmed.2008.08.021 10.1111/j.1553-2712.2012.01353.x 10.1016/j.injury.2012.01.001 10.2307/2529310 10.1001/jama.2010.1408 10.1148/radiol.10100640 |
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| DOI | 10.1016/j.ajem.2014.11.017 |
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| References | Landis, Koch (bb0020) 1977; 1 Rohacek, Albrecht, Kleim, Zimmermann, Exadaktylos (bb0030) 2012; 43 Kocher, Meurer, Fazel, Krumholz, Nallamothu (bb0010) 2011; 58 Kocher, Meurer, Desmond, Nallamothu (bb0035) 2012; 19 Larson, Johnson, Schnell, Salisbury, Forman (bb0005) 2011; 258 Korley, Pham, Kirsch (bb0025) 2010; 304 Jagoda, Bazarian, Bruns, Cantrill, Gean, Howard (bb0015) 2008; 52 Korley (10.1016/j.ajem.2014.11.017_bb0025) 2010; 304 Jagoda (10.1016/j.ajem.2014.11.017_bb0015) 2008; 52 Rohacek (10.1016/j.ajem.2014.11.017_bb0030) 2012; 43 Larson (10.1016/j.ajem.2014.11.017_bb0005) 2011; 258 Kocher (10.1016/j.ajem.2014.11.017_bb0010) 2011; 58 Landis (10.1016/j.ajem.2014.11.017_bb0020) 1977; 1 Kocher (10.1016/j.ajem.2014.11.017_bb0035) 2012; 19 |
| References_xml | – volume: 1 start-page: 159 year: 1977 end-page: 174 ident: bb0020 article-title: The measurement of observer agreement for categorical data publication-title: Biometrics contributor: fullname: Koch – volume: 19 start-page: 525 year: 2012 end-page: 534 ident: bb0035 article-title: Effect of testing and treatment on emergency department length of stay using a national database publication-title: Acad Emerg Med contributor: fullname: Nallamothu – volume: 58 start-page: 452 year: 2011 end-page: 453 ident: bb0010 article-title: National trends in use of computed tomography in the emergency department publication-title: Ann Emerg Med contributor: fullname: Nallamothu – volume: 258 start-page: 164 year: 2011 end-page: 173 ident: bb0005 article-title: National trends in CT use in the emergency department: 1995-2007 publication-title: Radiology contributor: fullname: Forman – volume: 52 start-page: 714 year: 2008 end-page: 748 ident: bb0015 article-title: Clinical policy: neuroimaging and decision making in adult mild traumatic brain injury in the acute setting publication-title: Ann Emerg Med contributor: fullname: Howard – volume: 43 start-page: 1415 year: 2012 end-page: 1418 ident: bb0030 article-title: Reasons for ordering computed tomography scans of the head in patients with minor brain injury publication-title: Injury contributor: fullname: Exadaktylos – volume: 304 start-page: 1465 year: 2010 end-page: 1471 ident: bb0025 article-title: Use of advanced radiology during visits to US emergency departments for injury-related conditions, 1998-2007 publication-title: JAMA contributor: fullname: Kirsch – volume: 58 start-page: 452 year: 2011 ident: 10.1016/j.ajem.2014.11.017_bb0010 article-title: National trends in use of computed tomography in the emergency department publication-title: Ann Emerg Med doi: 10.1016/j.annemergmed.2011.05.020 contributor: fullname: Kocher – volume: 52 start-page: 714 year: 2008 ident: 10.1016/j.ajem.2014.11.017_bb0015 article-title: Clinical policy: neuroimaging and decision making in adult mild traumatic brain injury in the acute setting publication-title: Ann Emerg Med doi: 10.1016/j.annemergmed.2008.08.021 contributor: fullname: Jagoda – volume: 19 start-page: 525 year: 2012 ident: 10.1016/j.ajem.2014.11.017_bb0035 article-title: Effect of testing and treatment on emergency department length of stay using a national database publication-title: Acad Emerg Med doi: 10.1111/j.1553-2712.2012.01353.x contributor: fullname: Kocher – volume: 43 start-page: 1415 year: 2012 ident: 10.1016/j.ajem.2014.11.017_bb0030 article-title: Reasons for ordering computed tomography scans of the head in patients with minor brain injury publication-title: Injury doi: 10.1016/j.injury.2012.01.001 contributor: fullname: Rohacek – volume: 1 start-page: 159 year: 1977 ident: 10.1016/j.ajem.2014.11.017_bb0020 article-title: The measurement of observer agreement for categorical data publication-title: Biometrics doi: 10.2307/2529310 contributor: fullname: Landis – volume: 304 start-page: 1465 year: 2010 ident: 10.1016/j.ajem.2014.11.017_bb0025 article-title: Use of advanced radiology during visits to US emergency departments for injury-related conditions, 1998-2007 publication-title: JAMA doi: 10.1001/jama.2010.1408 contributor: fullname: Korley – volume: 258 start-page: 164 year: 2011 ident: 10.1016/j.ajem.2014.11.017_bb0005 article-title: National trends in CT use in the emergency department: 1995-2007 publication-title: Radiology doi: 10.1148/radiol.10100640 contributor: fullname: Larson |
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| SubjectTerms | 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 |
| Title | Adherence to a clinical decision policy for head computed tomography in adult mild traumatic brain injury |
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