Head CT May Be Overused in Emergency Department

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Head CT scans may be overused in the emergency department for patients presenting with dizziness, near-syncope, and syncope.

Myles M. Mitsunaga, MD, of the University of Hawaii, and colleagues evaluated the electronic medical records of patients that underwent head CT in order to determine the amount of acutely abnormal findings, as well as any predicting factors of abnormal findings and hospital admission.

Of the 253 patients with dizziness, 7.1% had CT scans with abnormal findings and 18.6% were admitted. Of the 236 patients with syncope or near-syncope, 6.4% had CT scans with abnormal findings and 39.8% were admitted. Focal neurologic deficit (P = 0.003), age greater than 60 years (P = 0.011), and acute head trauma (P = 0.026) were found to be strongly correlated with acutely abnormal head CT findings.

The researchers concluded that most patients may not benefit from head CT unless they are older in age, have a focal neurologic deficit, or have recent head trauma. 

CT scan
Head CT May Be Overused in Emergency Department

The purpose of this study was to determine the yield of acutely abnormal findings on head CT scans in patients presenting to the emergency department with dizziness, near-syncope, or syncope and to determine the clinical factors that potentially predicted acutely abnormal head CT findings and hospital admission.

We retrospectively reviewed the electronic medical records of all patients presenting to an HMO emergency department between July 1, 2012, and December 31, 2012, who underwent head CT for a primary complaint of dizziness, syncope, or near-syncope.

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