We have located links that may give you full text access.
Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review
Utility of repeat head computed tomography after blunt head trauma: a systematic review.
Journal of Trauma 2006 July
BACKGROUND: Repeat head computed tomography (CT) is standard practice for head-injured patients at many trauma centers. Utilization of CT has increased over time, yet effects on outcome and associated risks are unknown. We systematically reviewed the literature to determine the incidence of progression of injury on repeat CT and resulting treatment changes.
METHODS: Studies were included from Medline, Embase, and a hand search of citations in reviewed articles. Main outcome measures were progression of injury on repeat CT and resulting intervention. Data were abstracted from 30 eligible studies and discrepancies were settled by consensus.
RESULTS: Progression of injury on repeat CT was evident in 8 to 67% of patients in the included studies. Neurosurgical intervention resulting subsequent to a repeat CT occurred in 0 to 54% of patients. More severe traumatic brain injury, defined by Glasgow Coma Scale, was associated with a higher proportion of patients with progression of injury on CT and subsequent neurosurgical interventions. Risk factors associated with progression of injury on CT or resulting intervention were inconsistently reported, but coagulopathy and injury severity were most commonly reported. Few studies reported changes in nonsurgical management, in-hospital disposition, or adverse events associated with obtaining repeat CTs.
CONCLUSION: Indications for repeat head CT after traumatic brain injury are unclear. The wide range of reported injury progression on CT and resulting surgical and medical treatment changes suggest there may be a subset of patients who benefit from repeat CT. Further research should stratify by severity of traumatic brain injury, clearly define inclusion and exclusion criteria, address selection bias, quantify progression of injury on CT, determine factors predictive of injury progression and intervention, and assess risks associated with repeat CT.
METHODS: Studies were included from Medline, Embase, and a hand search of citations in reviewed articles. Main outcome measures were progression of injury on repeat CT and resulting intervention. Data were abstracted from 30 eligible studies and discrepancies were settled by consensus.
RESULTS: Progression of injury on repeat CT was evident in 8 to 67% of patients in the included studies. Neurosurgical intervention resulting subsequent to a repeat CT occurred in 0 to 54% of patients. More severe traumatic brain injury, defined by Glasgow Coma Scale, was associated with a higher proportion of patients with progression of injury on CT and subsequent neurosurgical interventions. Risk factors associated with progression of injury on CT or resulting intervention were inconsistently reported, but coagulopathy and injury severity were most commonly reported. Few studies reported changes in nonsurgical management, in-hospital disposition, or adverse events associated with obtaining repeat CTs.
CONCLUSION: Indications for repeat head CT after traumatic brain injury are unclear. The wide range of reported injury progression on CT and resulting surgical and medical treatment changes suggest there may be a subset of patients who benefit from repeat CT. Further research should stratify by severity of traumatic brain injury, clearly define inclusion and exclusion criteria, address selection bias, quantify progression of injury on CT, determine factors predictive of injury progression and intervention, and assess risks associated with repeat CT.
Full text links
Related Resources
Trending Papers
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Prevention and treatment of ischaemic and haemorrhagic stroke in people with diabetes mellitus: a focus on glucose control and comorbidities.Diabetologia 2024 April 17
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Eosinophilic Esophagitis: Clinical Pearls for Primary Care Providers and Gastroenterologists.Mayo Clinic Proceedings 2024 April
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app