Brain computer tomography in critically ill patients--a prospective cohort study.

Area of Science:

• Neuroimaging
• Critical Care Medicine
• Diagnostic Radiology

Background:

• Brain computer tomography (brain CT) is crucial for diagnosing intracranial disorders.
• Intrahospital transport for brain CT in ICU patients carries inherent risks.
• The benefits of brain CT must outweigh the risks for critically ill patients.

Purpose of the Study:

• To critically evaluate the diagnostic yield of brain CT in ICU patients.
• To assess the therapeutic consequences of brain CT in critically ill patients.

Main Methods:

• Prospective observational study over one year.
• Data collected on reasons for brain CT, expected vs. actual findings, and treatment changes.
• Defined 'diagnostically positive' as new or increased abnormalities.

Main Results:

• Analyzed 225 brain CT scans in 175 ICU patients.
• 51% of brain CT scans were diagnostically positive (new or increased abnormalities).
• Treatment was changed in 19-33% of cases following a positive brain CT.

Conclusions:

• The diagnostic and therapeutic yield of brain CT in critically ill patients is moderate.
• Development of decision-rule guidelines for brain CT in ICU patients is necessary.