How necessary is the computerized brain tomography in minor head trauma?

BACKGROUND: Head trauma is a health problem that may be observed in all age groups, and it may cause significant losses in terms of health and economy. The purpose of our study is to evaluate the abnormal computerized brain tomography (CBT) prevalence and the rate of admission to brain surgery clinics in patients who applied to the Emergency Service Department for CBT due to minor head trauma.
METHODS: In the present study, the patients who were admitted to Afyonkarahisar Health Sciences University, Faculty of Medicine Hospital, Emergency Service Department between January 1st, 2017, and December 31st, 2017, due to head trauma and in who CBT was performed were examined retrospectively. The electronic files, CBTs, and consultation notes of these patients were accessed in the information system of the hospital.
RESULTS: A total of 43,389 patients who applied to the Emergency Service Department in 1 years’ time (2017) were examined retrospectively. As a result of the examination, it was determined that a total of 2,515 (5.7%) patients received CBT. The reason for a total of 1,152 (45%) of these patients was traumatic injury. It was determined that 618 (53.6%) of the patients in who CBT was performed due to trauma were aged <18 years; 280 (24.3%) patients were aged <2 years; 179 (15.5%) patients had to consult with the Brain Surgery Clinic; and 94 (8.1%) were hospitalized. It was also determined that there were abnormal computed tomography (CT) findings in only 68 (5.9%) of the patients in who CBT was performed.
CONCLUSION: The use of CBT indication criteria, which have been previously established and which reliability has been proven, in emergency trauma cases applying to the Emergency Service Department with minor head traumas may reduce the complication risk that may appear as a result of an unnecessary CBT and avoid complications that may occur in the long run due to CBT.

Minör kafa travmasýnda bilgisayarlý beyin tomografisi ne kadar gerekli?

AMAÇ: Kafa travmalarý tüm yaþ gruplarýnda görülebilen, saðlýk ve ekonomi açýsýndan önemli kayýplara neden olabilen bir saðlýk sorunudur. Çalýþmamýzýn amacý, acil servise minör kafa travmasý nedeniyle baþvuran ve bilgisayarlý beyin tomografisi (BBT) çekilen hastalarda, anormal BBT prevalansýný ve beyin cerrahi kliniðine yatýþ oranlarýný deðerlendirmektir.
GEREÇ VE YÖNTEM: Çalýþmada Afyonkarahisar Saðlýk Bilimleri Üniversitesi Týp Fakültesi Hastanesi Acil Servisi’ne 01.01.2017–31.12.2017 tarihleri arasýnda kafa travmasý nedeniyle gelen ve BBT çekilen hastalar geriye dönük olarak incelendi. Hastane bilgi sisteminden bu hastalarýn elektronik dosyalarýna, BBT’lerine ve konsültasyon notlarýna ulaþýldý.
BULGULAR: Bir yýllýk (2017) süre içerisinde acil servise baþvuru yapan 43.389 hastaya ulaþýldý. Ýnceleme sonucunda 2515 (%5.7) hastaya BBT çekildiði saptandý. Bu hastalarýn 1152’sinin (%45) baþvuru nedeni travma idi. Travmaya baðlý olarak BBT çekilen 618 (%53.6) hastanýn 18 yaþ altý olduðu, 280 (%24.3) hastanýn iki yaþ altý olduðu, 179 (%15.5) hastanýn beyin cerrahisi kliniði ile konsülte edildiði ve 94 (%8.1) hastaya yatýþ verildiði saptandý. BBT çekilen sadece 68 (%5.9) hastada anormal BT bulgularý saptandý.
TARTIÞMA: Acil servise minör kafa travmasý ile gelenlerde, daha önce tespit edilen ve güvenilirliði kanýtlanan BBT çekim endikasyon kriterlerinin kullanýlmasý, düþük riskli hastalarýn takip edilmesi, gereksiz BBT çekimlerini ve çekime baðlý uzun dönemde geliþebilecek komplikasyonlarý azaltabilir.