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Management of mild traumatic brain injury–trauma energy level and medical history as possible predictors for intracranial hemorrhage
PURPOSE: Head trauma is common in the emergency department. Identifying the few patients with serious injuries is time consuming and leads to many computerized tomographies (CTs). Reducing the number of CTs would reduce cost and radiation. The aim of this study was to evaluate the characteristics of...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791960/ https://www.ncbi.nlm.nih.gov/pubmed/29550926 http://dx.doi.org/10.1007/s00068-018-0941-8 |
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author | Vedin, Tomas Svensson, Sebastian Edelhamre, Marcus Karlsson, Mathias Bergenheim, Mikael Larsson, Per-Anders |
author_facet | Vedin, Tomas Svensson, Sebastian Edelhamre, Marcus Karlsson, Mathias Bergenheim, Mikael Larsson, Per-Anders |
author_sort | Vedin, Tomas |
collection | PubMed |
description | PURPOSE: Head trauma is common in the emergency department. Identifying the few patients with serious injuries is time consuming and leads to many computerized tomographies (CTs). Reducing the number of CTs would reduce cost and radiation. The aim of this study was to evaluate the characteristics of adults with head trauma over a 1-year period to identify clinical features predicting intracranial hemorrhage. METHODS: Medical record data have been collected retrospectively in adult patients with traumatic brain injury. A total of 1638 patients over a period of 384 days were reviewed, and 33 parameters were extracted. Patients with high-energy multitrauma managed with ATLS™ were excluded. The analysis was done with emphasis on patient history, clinical findings, and epidemiological traits. Logistic regression and descriptive statistics were applied. RESULTS: Median age was 58 years (18–101, IQR 35–77). High age, minor head injury, new neurological deficits, and low trauma energy level correlated with intracranial hemorrhage. Patients younger than 59 years, without anticoagulation or antiplatelet therapy who suffered low-energy trauma, had no intracranial hemorrhages. The hemorrhage frequency in the entire cohort was 4.3% (70/1638). In subgroup taking anticoagulants, the frequency of intracranial hemorrhage was 8.6% (10/116), and in the platelet-inhibitor subgroup, it was 11.8% (20/169). CONCLUSION: This study demonstrates that patients younger than 59 years with low-energy head trauma, who were not on anticoagulants or platelet inhibitors could possibly be discharged based on patient history. Maybe, there is no need for as extensive medical examination as currently recommended. These findings merit further studies. |
format | Online Article Text |
id | pubmed-6791960 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-67919602019-10-17 Management of mild traumatic brain injury–trauma energy level and medical history as possible predictors for intracranial hemorrhage Vedin, Tomas Svensson, Sebastian Edelhamre, Marcus Karlsson, Mathias Bergenheim, Mikael Larsson, Per-Anders Eur J Trauma Emerg Surg Original Article PURPOSE: Head trauma is common in the emergency department. Identifying the few patients with serious injuries is time consuming and leads to many computerized tomographies (CTs). Reducing the number of CTs would reduce cost and radiation. The aim of this study was to evaluate the characteristics of adults with head trauma over a 1-year period to identify clinical features predicting intracranial hemorrhage. METHODS: Medical record data have been collected retrospectively in adult patients with traumatic brain injury. A total of 1638 patients over a period of 384 days were reviewed, and 33 parameters were extracted. Patients with high-energy multitrauma managed with ATLS™ were excluded. The analysis was done with emphasis on patient history, clinical findings, and epidemiological traits. Logistic regression and descriptive statistics were applied. RESULTS: Median age was 58 years (18–101, IQR 35–77). High age, minor head injury, new neurological deficits, and low trauma energy level correlated with intracranial hemorrhage. Patients younger than 59 years, without anticoagulation or antiplatelet therapy who suffered low-energy trauma, had no intracranial hemorrhages. The hemorrhage frequency in the entire cohort was 4.3% (70/1638). In subgroup taking anticoagulants, the frequency of intracranial hemorrhage was 8.6% (10/116), and in the platelet-inhibitor subgroup, it was 11.8% (20/169). CONCLUSION: This study demonstrates that patients younger than 59 years with low-energy head trauma, who were not on anticoagulants or platelet inhibitors could possibly be discharged based on patient history. Maybe, there is no need for as extensive medical examination as currently recommended. These findings merit further studies. Springer Berlin Heidelberg 2018-03-17 2019 /pmc/articles/PMC6791960/ /pubmed/29550926 http://dx.doi.org/10.1007/s00068-018-0941-8 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Article Vedin, Tomas Svensson, Sebastian Edelhamre, Marcus Karlsson, Mathias Bergenheim, Mikael Larsson, Per-Anders Management of mild traumatic brain injury–trauma energy level and medical history as possible predictors for intracranial hemorrhage |
title | Management of mild traumatic brain injury–trauma energy level and medical history as possible predictors for intracranial hemorrhage |
title_full | Management of mild traumatic brain injury–trauma energy level and medical history as possible predictors for intracranial hemorrhage |
title_fullStr | Management of mild traumatic brain injury–trauma energy level and medical history as possible predictors for intracranial hemorrhage |
title_full_unstemmed | Management of mild traumatic brain injury–trauma energy level and medical history as possible predictors for intracranial hemorrhage |
title_short | Management of mild traumatic brain injury–trauma energy level and medical history as possible predictors for intracranial hemorrhage |
title_sort | management of mild traumatic brain injury–trauma energy level and medical history as possible predictors for intracranial hemorrhage |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791960/ https://www.ncbi.nlm.nih.gov/pubmed/29550926 http://dx.doi.org/10.1007/s00068-018-0941-8 |
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