Neurocognitive assessment in patients with a minor traumatic brain injury and an abnormal initial CT scan: Can cognitive evaluation assist in identifying patients who require surveillance CT brain imaging?
| Autor: | Michael B. Dunham, Carolyn Gratton, Andrew W Kirkpatrick, Chad G. Ball, Ruphus Rajakumar, Thomas W. Clements, Paul B. McBeth, Rohan Lall |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Traumatic brain injury Computed tomography Neuropsychological Tests behavioral disciplines and activities 03 medical and health sciences 0302 clinical medicine Cog mental disorders Brain Injuries Traumatic medicine Humans In patient Glasgow Coma Scale Retrospective Studies Health Services Needs and Demand medicine.diagnostic_test business.industry 030208 emergency & critical care medicine General Medicine Length of Stay Middle Aged medicine.disease Surgery Female Radiology Neurosurgery Cognitive Assessment System Ct brain business Cognition Disorders Tomography X-Ray Computed human activities Neurocognitive 030217 neurology & neurosurgery |
| Zdroj: | American journal of surgery. 215(5) |
| ISSN: | 1879-1883 |
| Popis: | Evidence for repeat computed tomography (CT) in minor traumatic brain injury (mTBI) patients with intracranial pathology is scarce. The aim of this study was to investigate the utility of clinical cognitive assessment (COG) in defining the need for repeat imaging.COG performance was compared with findings on subsequent CT, and need for neurosurgery in mTBI patients (GCS 13-15 and positive CT findings).Of 152 patients, 65.8% received a COG (53.0% passed). Patients with passed COG underwent fewer repeat CT (43.4% vs. 78.7%; p = .001) and had shorter LOS (8.7 vs. 19.5; p .05). Only 1 patient required neurosurgery after a passed COG. The negative predictive value of a normal COG was 90.6% (95%CI = 81.8%-95.4%).mTBI patients with an abnormal index CT who pass COG are less likely to undergo repeat CT head, and rarely require neurosurgery. The COG warrants further investigation to determine its role in omitting repeat head CT. |
| Databáze: | OpenAIRE |
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