Comparison of the efficiency of the paediatric brain CTs with trauma and non-trauma related indications in the paediatric emergency department

Abstract

BACKGROUND:This study aimed to determine the appropriateness of the examinations by evaluating the pre-diagnosis of the patients who underwent brain Computed Tomography (CT) in the paediatric emergency departments and the existing pathologies in the brain CTs. In addition, a comparison of the efficiency of the brain CT examinations performed for trauma and non-traumatic reasons was made. MATERIAL AND METHODS:CT's were examined by dividing into 2 groups according to the indications as trauma (group 1) and non-trauma related (group 2). The 2 groups were compared statistically according to the number of pathologies, distribution of pathologies by gender and age. RESULTS:Pathologies were detected in 9.3% (n = 30) of the patients in the first group and 21.2% (n = 14) of the patients in the second group. A statistically significant difference was found between the groups in terms of whether pathology was detected (p = 0.023). The rate of pathology detection in the group that underwent CT for non-traumatic reasons was statistically significantly higher than the other group. CONCLUSION:Precautions should be taken especially with trauma patients to prevent unnecessary CT scans in the paediatric emergency department. In addition, if a CT scan is planned in the paediatric emergency department with the approval of the paediatrician and radiologist, the CT examinations can be made with more accurate indications.

comparison of pathological findings in head computed to-mography with clinical presentation of pediatric patients in the Emergency Department

“…post traumatic and nontraumatic. Dogan et al reported that 83% CT scans of the head performed in the EDs are injury-related and the rest (17%) come from non-traumatic reasons [7]. In the study, traumatic lesions observable on CT were found in 19.8% of the examined children, while 80.2% had non-traumatic lesions.…”

“…The preliminary diagnoses of patients who underwent a CT for other than traumatic causes, include with decreasing incidence: headaches, seizures, fever, confusion, hematoma, infarct, optic neuritis and arrest [7]. In the study headaches are also the most common indication for non-traumatic reason.…”

“…It can give results quickly, allowing potentially lifesaving decisions to be made. CT of the head is the most common CT scan performed in EDs and it can be divided into two categories: post-traumatic and non-traumatic CT head [1,7].…”

“…After obtaining a medical history and physical examination, preliminary diagnoses of patients with non-traumatic reasons that may be an indication for head CT include: headache, seizures, fewer, confusion, hematoma, infarct, optic neuritis and arrest [7]. However, there are no guidelines for performing head CT in non-traumatic patients in literature.…”