The Canadian Head CT Rule; A Hospital Audit

Background: Minor head trauma is one of the leading cause of emergency department visits worldwide. The Canadian Head CT-scan rule (CCHR) in minor head injury is an evidence-based aid in decision making as regards to use of CT-scans to detect head injury requiring neuro-intervention. It therefore av...

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Main Author: John Kinyua
Format: Article
Language:English
Published: Surgical Society of Kenya 2018-07-01
Series:The Annals of African Surgery
Subjects:
Online Access:https://www.annalsofafricansurgery.com/the-canadian-head-ct-rule-a-hospita
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author John Kinyua
author_facet John Kinyua
author_sort John Kinyua
collection DOAJ
description Background: Minor head trauma is one of the leading cause of emergency department visits worldwide. The Canadian Head CT-scan rule (CCHR) in minor head injury is an evidence-based aid in decision making as regards to use of CT-scans to detect head injury requiring neuro-intervention. It therefore avoids wastage of resources. The objective was to compare the number of CT-scans done for minor head injury as compared to the number that would have been done if the CCHR was applied. Methods: A retrospective study was done. All patients resenting with minor head injury (GCS 13-15) were identified from the hospital registry and their files obtained. Patients not meeting the CCHR criteria excluded. Ten parameters were extracted and tabulated. Results: Forty-one patients were included with three exclusions. 89% (n=34) of the patients presented with a 2-hour GCS of 13 or more. 11% (n=4) were suspicious of base skull fractures. 23% (n=9) had signs of open fracture. Vomiting was seen in 2 patients (5%). The mean age of patients was 29 years. 2 patients (5%) reported amnesia. All the patients had a CT scan done. Fourteen patients would have required CT scans had the rule been used. Positive findings were noted in seven of the patients who qualified and in three who did not. This demonstrated a 50% positive predictive value, a negative predictive value of 89%, a sensitivity 70% and 75% specificity. Conclusion: Use of CCHR would reduce unnecessary use of CT scans in minor head injury in this setup.
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spelling doaj.art-98a0448705a94ff1b949c2a351d4b3e12022-12-21T22:12:15ZengSurgical Society of KenyaThe Annals of African Surgery1999-96742523-08162018-07-011525761The Canadian Head CT Rule; A Hospital AuditJohn Kinyua0Coast General HospitalBackground: Minor head trauma is one of the leading cause of emergency department visits worldwide. The Canadian Head CT-scan rule (CCHR) in minor head injury is an evidence-based aid in decision making as regards to use of CT-scans to detect head injury requiring neuro-intervention. It therefore avoids wastage of resources. The objective was to compare the number of CT-scans done for minor head injury as compared to the number that would have been done if the CCHR was applied. Methods: A retrospective study was done. All patients resenting with minor head injury (GCS 13-15) were identified from the hospital registry and their files obtained. Patients not meeting the CCHR criteria excluded. Ten parameters were extracted and tabulated. Results: Forty-one patients were included with three exclusions. 89% (n=34) of the patients presented with a 2-hour GCS of 13 or more. 11% (n=4) were suspicious of base skull fractures. 23% (n=9) had signs of open fracture. Vomiting was seen in 2 patients (5%). The mean age of patients was 29 years. 2 patients (5%) reported amnesia. All the patients had a CT scan done. Fourteen patients would have required CT scans had the rule been used. Positive findings were noted in seven of the patients who qualified and in three who did not. This demonstrated a 50% positive predictive value, a negative predictive value of 89%, a sensitivity 70% and 75% specificity. Conclusion: Use of CCHR would reduce unnecessary use of CT scans in minor head injury in this setup.https://www.annalsofafricansurgery.com/the-canadian-head-ct-rule-a-hospitacanadianheadct scanruleminor head injury
spellingShingle John Kinyua
The Canadian Head CT Rule; A Hospital Audit
The Annals of African Surgery
canadian
head
ct scan
rule
minor head injury
title The Canadian Head CT Rule; A Hospital Audit
title_full The Canadian Head CT Rule; A Hospital Audit
title_fullStr The Canadian Head CT Rule; A Hospital Audit
title_full_unstemmed The Canadian Head CT Rule; A Hospital Audit
title_short The Canadian Head CT Rule; A Hospital Audit
title_sort canadian head ct rule a hospital audit
topic canadian
head
ct scan
rule
minor head injury
url https://www.annalsofafricansurgery.com/the-canadian-head-ct-rule-a-hospita
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