Asunto(s)
Hernia/etiología , Herniorrafia/instrumentación , Región Lumbosacra/lesiones , Anclas para Sutura , Heridas y Lesiones/cirugía , Accidentes de Tránsito , Adulto , Hernia/diagnóstico por imagen , Herniorrafia/métodos , Humanos , Región Lumbosacra/diagnóstico por imagen , Región Lumbosacra/cirugía , Masculino , Técnicas de Sutura , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Heridas y Lesiones/complicaciones , Heridas y Lesiones/diagnóstico por imagenRESUMEN
BACKGROUND: 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. METHODS: COG performance was compared with findings on subsequent CT, and need for neurosurgery in mTBI patients (GCS 13-15 and positive CT findings). RESULTS: Of 152 patients, 65.8% received a COG (53.0% passed). Patients with passed COG underwent fewer repeat CT (43.4% vs. 78.7%; pâ¯=â¯.001) and had shorter LOS (8.7 vs. 19.5; pâ¯<â¯.05). Only 1 patient required neurosurgery after a passed COG. The negative predictive value of a normal COG was 90.6% (95%CIâ¯=â¯81.8%-95.4%). CONCLUSION: 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.