头部计算机断层扫描在急诊室对老年患者的评估,具有普遍的虚弱
Elizabeth A Calhoun1,2, Richard D Shih1,2, Patrick G Hughes1,2
1Department of Emergency Medicine Florida Atlantic University Charles E. Schmidt College of Medicine Boca Raton Florida USA.
概括
头部CT扫描很少在老年急诊室患者中检测到急性内异常. 客观弱点或神经学缺陷增加了发现的可能性,但整体效用很低.
科学领域:
- 老年急救医学的医学
- 神经成像诊断 诊断 神经成像诊断
- 神经学 神经学
背景情况:
- 普遍的虚弱是老年急诊室 (ED) 患者的常见,复杂的投诉.
- 脑部计算机断层扫描 (CT) 对该群体急性衰弱的诊断收益率尚未确立.
- 评估老年衰弱需要仔细考虑诊断成像效用.
研究的目的:
- 评估头部CT扫描对老年患者急性全身虚弱的诊断效用.
- 为了确定这种患者群体中头部CT急性内发现的发生率.
- 为了确定脑部CT检测结果在衰弱的老年患者中呈阳性的预测因素.
主要方法:
- 在社区ED中对247名65岁以上的全身虚弱患者进行了头部CT的回顾性审查.
- 排除标准包括焦点神经病情,精神状态改变或创伤.
- 主要结局是急性内异常;次要结局包括咨询和干预.
主要成果:
- 只有3.2%的患者在头部CT上有急性内异常.
- 具有客观弱点或焦点神经学缺陷的患者更有可能有积极的发现 (8.5%对2.0%).
- 神经学或神经外科咨询很少发生,没有患者需要神经外科干预.
结论:
- 头部CT在评估老年ED患者急性全身性衰弱时具有较低的诊断效用.
- 在检查时,急性内发现的可能性随着客观弱点或神经学缺陷的增加而增加.
- 常规头部CT可能对衰弱和正常体检的老年患者没有好处.
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