Overuse of CT for Minor Head Trauma Patients: A Retrospective Analysis from Poland and Lithuania Trauma Centres

<i>Background and Objectives</i>: Head trauma is one of many conditions that trauma centres deal with daily. This study aimed to analyse the utilisation of head CT scans for patients with minor head trauma in two major hospitals in Lithuania and Poland. <i>Materials and Methods<...

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Main Authors: Kristina Blažienė, Jakub Nożewski, Vaida Cibulskė, Monika Kunigonytė, Deimantė Košytė, Karolis Bareikis, Vytautas Aukštakalnis
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/60/12/1908
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author Kristina Blažienė
Jakub Nożewski
Vaida Cibulskė
Monika Kunigonytė
Deimantė Košytė
Karolis Bareikis
Vytautas Aukštakalnis
author_facet Kristina Blažienė
Jakub Nożewski
Vaida Cibulskė
Monika Kunigonytė
Deimantė Košytė
Karolis Bareikis
Vytautas Aukštakalnis
author_sort Kristina Blažienė
collection DOAJ
description <i>Background and Objectives</i>: Head trauma is one of many conditions that trauma centres deal with daily. This study aimed to analyse the utilisation of head CT scans for patients with minor head trauma in two major hospitals in Lithuania and Poland. <i>Materials and Methods</i>: We conducted a retrospective, descriptive study of CT utilisation in minor head trauma patients presenting to the Level 1 trauma centre Hospital of the Lithuanian University of Health Sciences Kaunas Clinics (HLUHS KC) and Jan Biziel University Hospital in Bydgoszcz emergency departments (EDs), during the study period from 01 February to 30 April 2023. <i>Results</i>: During the study period, 1048 patients visited the HLUHS KC emergency department (ED) due to head trauma, and 388 patients visited the Jan Biziel University Hospital. Overall, 611 patients were included in the study. Most of the patients (92%) who suffered minimal trauma were younger than 65 years old. Eighty-two per cent of the patients older than 65 years old arrived at the ED after suffering a fall. Almost all the patients who were using antiplatelets (93%) or anticoagulants (91%) had CT scans. Non-emergency medicine (EM) physicians were more likely to order head CT scans than EM physicians (170 (83%) vs. 249 (62%), <i>p</i> < 0.001). There were 33 (5%) CT scans with traumatic features, and 8 (1%) of these were categorised as clinically significant. Patients who suffered clinically significant head trauma were more likely to be on anticoagulants and older than 65 when compared to normal/insignificant CT findings: 3 (38%) vs. 25 (6%), <i>p</i> < 0.001; and 6 (75%) vs. 146 (36%), <i>p</i> < 0.021. <i>Conclusions</i>: A significant number of head CT scans performed were not necessary according to existing head CT guidelines and risk calculators. However, even in minor head traumas, clinically significant head injuries may occur.
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spelling doaj-art-05ee7d5f5c984d398799c5e056312e9e2024-12-27T14:38:29ZengMDPI AGMedicina1010-660X1648-91442024-11-016012190810.3390/medicina60121908Overuse of CT for Minor Head Trauma Patients: A Retrospective Analysis from Poland and Lithuania Trauma CentresKristina Blažienė0Jakub Nożewski1Vaida Cibulskė2Monika Kunigonytė3Deimantė Košytė4Karolis Bareikis5Vytautas Aukštakalnis6Emergency Medicine Department, Lithuanian University of Health Sciences, 44307 Kaunas, LithuaniaEmergency Medicine Department, Jan Biziel University Hospital no 2, 85-168 Bydgoszcz, PolandEmergency Medicine Department, Lithuanian University of Health Sciences, 44307 Kaunas, LithuaniaEmergency Medicine Department, Lithuanian University of Health Sciences, 44307 Kaunas, LithuaniaEmergency Medicine Department, Lithuanian University of Health Sciences, 44307 Kaunas, LithuaniaDepartment of Neurosurgery, Lithuanian University of Health Sciences, 44307 Kaunas, LithuaniaEmergency Medicine Department, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania<i>Background and Objectives</i>: Head trauma is one of many conditions that trauma centres deal with daily. This study aimed to analyse the utilisation of head CT scans for patients with minor head trauma in two major hospitals in Lithuania and Poland. <i>Materials and Methods</i>: We conducted a retrospective, descriptive study of CT utilisation in minor head trauma patients presenting to the Level 1 trauma centre Hospital of the Lithuanian University of Health Sciences Kaunas Clinics (HLUHS KC) and Jan Biziel University Hospital in Bydgoszcz emergency departments (EDs), during the study period from 01 February to 30 April 2023. <i>Results</i>: During the study period, 1048 patients visited the HLUHS KC emergency department (ED) due to head trauma, and 388 patients visited the Jan Biziel University Hospital. Overall, 611 patients were included in the study. Most of the patients (92%) who suffered minimal trauma were younger than 65 years old. Eighty-two per cent of the patients older than 65 years old arrived at the ED after suffering a fall. Almost all the patients who were using antiplatelets (93%) or anticoagulants (91%) had CT scans. Non-emergency medicine (EM) physicians were more likely to order head CT scans than EM physicians (170 (83%) vs. 249 (62%), <i>p</i> < 0.001). There were 33 (5%) CT scans with traumatic features, and 8 (1%) of these were categorised as clinically significant. Patients who suffered clinically significant head trauma were more likely to be on anticoagulants and older than 65 when compared to normal/insignificant CT findings: 3 (38%) vs. 25 (6%), <i>p</i> < 0.001; and 6 (75%) vs. 146 (36%), <i>p</i> < 0.021. <i>Conclusions</i>: A significant number of head CT scans performed were not necessary according to existing head CT guidelines and risk calculators. However, even in minor head traumas, clinically significant head injuries may occur.https://www.mdpi.com/1648-9144/60/12/1908minor head traumaoveruse of head CTminor head injury
spellingShingle Kristina Blažienė
Jakub Nożewski
Vaida Cibulskė
Monika Kunigonytė
Deimantė Košytė
Karolis Bareikis
Vytautas Aukštakalnis
Overuse of CT for Minor Head Trauma Patients: A Retrospective Analysis from Poland and Lithuania Trauma Centres
Medicina
minor head trauma
overuse of head CT
minor head injury
title Overuse of CT for Minor Head Trauma Patients: A Retrospective Analysis from Poland and Lithuania Trauma Centres
title_full Overuse of CT for Minor Head Trauma Patients: A Retrospective Analysis from Poland and Lithuania Trauma Centres
title_fullStr Overuse of CT for Minor Head Trauma Patients: A Retrospective Analysis from Poland and Lithuania Trauma Centres
title_full_unstemmed Overuse of CT for Minor Head Trauma Patients: A Retrospective Analysis from Poland and Lithuania Trauma Centres
title_short Overuse of CT for Minor Head Trauma Patients: A Retrospective Analysis from Poland and Lithuania Trauma Centres
title_sort overuse of ct for minor head trauma patients a retrospective analysis from poland and lithuania trauma centres
topic minor head trauma
overuse of head CT
minor head injury
url https://www.mdpi.com/1648-9144/60/12/1908
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