计算机断层扫描成像老年患者的不确定的头部创伤
Michael L Turchiaro1, Joshua J Solano1, Lisa M Clayton1
1Department of Emergency Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, Florida; Department of Emergency Medicine, Delray Medical Center, Delray Beach, Florida.
The Journal of emergency medicine
|October 14, 2023
概括
老年患者头部受伤不确定,其内出血 (ICH) 风险较低,但仍然需要进行头部CT扫描. 尽管在不确定的创伤病例中ICH率较低,但这种成像是至关重要的.
科学领域:
- 紧急医疗 紧急医疗
- 神经外科 神经外科
- 老年医学 老年医学
背景情况:
- 对头部受伤的临床决策规则存在,但缺乏评估未知的创伤事件的工具.
- 患有不确定的创伤的患者可能会接受不必要的脑部成像,增加成本和辐射暴露.
研究的目的:
- 评估老年患者的风险因素和结果,这些老年患者头部受伤不确定.
- 为了确定患有不确定的头部创伤的老年患者是否需要头部CT扫描.
主要方法:
- 一项前性队列研究,涉及两个急诊室的老年患者,这些患者头部受伤确定的或不确定的.
- 患者根据病史和体检进行分类;结果包括内出血 (ICH),神经外科干预和死亡率.
- 评估了诸如性别,酒精使用,抗血小板使用和格拉斯哥昏迷表 (GCS) 等风险因素.
主要成果:
- 在确定的头部创伤 (10.7%) 和不确定的头部创伤 (1.5%) 中,内出血 (ICH) 的发生率显著更高.
- 在确定的头部创伤 (1.2%) 与不确定的头部创伤 (0.3%) 相比,神经外科干预率也更高.
- 在确定的和不确定的头部创伤组之间没有观察到死亡率的显著差异.
结论:
- 尽管发病率较低,但老年患者头部受伤不确定的ICH风险足够显著,可以进行头部CT成像.
- 目前的风险因素没有确定在不确定的创伤组内具有增加ICH风险的特定患者亚组.
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