[Could the head CT scans be reduced for patients with minor head injury in the emergency practice?]

Introduction: Skull and brain injuries (craniocerebral traumas) should be classified according to internationally accepted standards, their frequency and distribution varies from country to country. The frequency of skull and brain injuries in Hungary varies about 2,000 skull injuries per 100,000 inhabitants. No more than a quarter of them involve hospitalization. The number of CT examinations performed in the United States and in our country has doubled in the past 20–30 years. Nearly 90% of the skull CT scans are negative. Patients with minimal head injuries do not experience loss of consciousness or other neurological changes and have GCS values of 13–15. Following observation, the majority of patients with these minor injuries could be discharged without any consequences. Objective: The inefficient use of CT examinations significantly increases unnecessary radiation doses and health care costs. To mitigate these, there are several well-proven regulatory systems in force abroad. However, their use has not yet become a routine in our country. Our aim was to investigate how the number of head CT scans in our emergency unit could have been reduced. Method: In this study, we examined the method of care for patients with cranial injuries presenting at the Békés County Emergency Department. Results: Results of this retrospective analysis, compared with the Canadian Cranial CT Rules, suggest that the number of urgent cranial CT examinations could have been reduced by 70%. Conclusion: Applying the standard systems that have already been efficient abroad, it would be significantly possible to improve the efficiency of care for minor head injuries in Hungarian emergency practice as well. Orv Hetil. 2024; 165(14): 538–544.