Covino et al reported a clinical score for identifying a non-trauma patient in the Emergency Department who may have a positive head CT scan. This can help to identify a patient who should have an immediate imaging study. The authors are from Fondazione Policlinico Universitario A. Gemelli IRCCS and Universita Cattolica del Sacro Cuore in Rome.
Patient selection: non-trauma patient in the Emergency Department
Predictors:
(1) any neurological deficit on physical exam (OR 10.4)
(2) new onset of acute headache (OR 6.8)
(3) both (new onset seizures) AND (altered state of consciousness) (OR 3.6)
(4) any transient neurological disorder (OR 1.8)
Interpretation:
• minimum number of predictors present: 0
• maximum number of predictors: 4
Number of Predictors
Percent with Abnormal Head CT
0
0%
1
5.2%
2
18.1%
3
46.6%
4
70.6%
Performance:
• The area under the ROC curve was 0.83.
• The sensitivity was 100% but the specificity was 21% (lots of false positives).
To read more or access our algorithms and calculators, please log in or register.
