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Svrha rada: analizirati vrijeme proteklo od početka obrade do CT-a, učestalost ozljede mozga i simptoma kod bolesnika s GCS vrijednosti 15, 14 i 13 i različitim koncentracijama alkohola u krvi zaprimljenih u Centar za hitnu medicinu KBC-a Rijeka u razdoblju od 01. lipnja do 31. prosinca 2015. godine. Ispitanici i postupci: analiza je obuhvatila 103 bolesnika zaprimljena u CZHM KBC Rijeka sa sumnjom na ozljedu mozga u razdoblju od 01. lipnja do 31. prosinca 2015. Rezultati: u 85% bolesnika CT mozga učinjen je unutar tri sata od početne obrade. Učestalost ozljede mozga je obrnuto proporcionalna GCS vrijednosti. Najveći broj bolesnika imalo je RAK >2 g/L. Kod polovice bolesnika s RAK >2 g/L i GCS vrijednosti 14 i 13 nije bilo ozljede mozga. Simptomi ozljede mozga bili su prisutni u bolesnika s GCS 15 koji su upućeni na CT mozga. Simptomi bolesnika GCS 14 i 13 prema koncentraciji alkohola bili su podjednako raspoređeni. Zaključak: U polovice bolesnika s GCS 14 i 13 i RAK >2 g/L nije bilo ozljede mozga, pa je moguće da je alkohol u istih vrlo vjerojatno utjecao na pad vrijednost GCS-a. Klinička slika utjecala je na odluku za upućenje na CT mozga bolesnika s GCS 15. Korištenje bolničkog protokola moglo bi značajno smanjiti vrijeme od početka obrade bolesnika do CT dijagnostike u bolesnika u kojih bi se moglo raditi o ozljedi mozga, a s druge strane ne opterećivati sofisticiranu CT dijagnostiku ako se u bolesnika radi o intoksikaciji alkoholom s manjom ozljedom glave bez ozljede mozga. Aims of research: to analyze the time passed between first contact and CT scan, the frequency of traumatic brain injury (TBI) and symptoms in patients with GCS scores 15, 14, 13 and different blood alcohol concentrations (BAC), that are hospitalized in the Emergency Department Unit (EDU) of the Clinical Hospital Centre (CHC) Rijeka from June 1st to December 31st 2015. Examinees and actions: analysis included 103 patients with a suspicion of TBI that were hospitalized in the EDU of the CHC Rijeka from June 1st to December 31st 2015. Results: In 85% of the patients CT scan was performed within three hours from the first contact. The frequency of TBI is inversely proportional to GCS score. Most patients had BAC >2g/L. Half of the patients with BAC >2g/L and GCS score 14 and 13 had no evident TBI. Patients with TBI symptoms and GCS score 15 were subjected to CT scan. TBI symptoms in patients with GCS score 14 and 13 were equally distributed considering BAC. Conclusion: 50% of the patients with GCS 14 and 13 and BAC >2g/L had no evident TBI, therefore it’s possible that alcohol influenced the drop in their GCS score. Clinical status influenced the CT brain scan decision for the GCS score 15 patients. Hospital protocol use could significantly reduce the time passed from first contact to CT scans in patients suspected to have TBI. Furthermore, the protocol could reduce unnecessary CT usage in case of alcohol intoxication resulting with minor head injury. |
