Muakkassa et al reported factors associated with a positive repeat head CT scan following an initially negative head CT scan performed after blunt trauma. The authors are from Akron General Medical Center and Northeast Ohio Medical University.
Patient selection: blunt trauma with initial head CT scan negative
Reasons for repeating the head CT scan:
(1) change in neurologic status including decrease in mental status
(2) persistent neurologic symptoms
(3) suspected intracranial bleed
(4) followup
Parameters:
(1) ISS on admission
(2) intubation
Parameter
Finding
Points
ISS
<= 15
0
> 15
1
intubation
no
0
yes
1
number of predictors =
= SUM(points for the 2 parameters)
Interpretation:
• minimum number of predictors: 0
• maximum number of predictors: 2
• The chances of having a positive repeat scan increased with the number of predictors.
The presence of a lower Glasgow Coma Score (GCS) on admission (GCS < 9) was associated with a positive repeat study but this did not reach statistical significance.
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