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Internal and Emergency Medicine

, Volume 12, Issue 1, pp 81–89 | Cite as

Utility of repeat head computed tomography after mild head trauma: influence on short- and long-term prognosis and health-related quality of life

  • Francesca InnocentiEmail author
  • Beatrice Del Taglia
  • Irene Tassinari
  • Federica Trausi
  • Alberto Conti
  • Maurizio Zanobetti
  • Riccardo Pini
EM – Original

Abstract

The aim of this study was to investigate the utility of repeat head CT in a large population of patients with non-isolated blunt mild head trauma (MTBI), especially in the presence of intracranial injury. This is a study of a cohort of 478 non-isolated MTBI patients admitted to the High Dependency Unit of the Emergency Department of the University-Hospital of Florence from July 2008 to December 2013. Results of initial and subsequent head CT scans, and indications for repeat head CT scan (routine vs. neurologic change) were recorded. The study population was divided into two subgroups: 28 (6 %) patients with neurological change or persistently reduced GCS (group GCS−) and 450 (94 %) patients with normal or improving GCS (group GCS+). After 6 months from the event, a telephone interview using SF12 questionnaire was conducted. Among GCS− patients, the admission CT scan showed intracranial lesions (ICI) in 16 (57 %) patients; only two patients had a TBI-related neurosurgical intervention. Among GCS+ patients, the first CT scan showed an ICI in 133 patients; in a significant proportion of patients with ICI at the first CT scan, the injury worsened (40/133, 30 %, p < 0.0001). However, no GCS+ patient had any neurosurgical intervention. We observed a significant reduction in both MCS and PCS scores after the injury compared with the previous period. The number of repeat CT scan was high in patients who presented ICI at the first CT scan; however, no patient with ICI and normal or improving GCS score needed a neurosurgical intervention.

Keywords

Mild traumatic brain injury Intracranial lesions Repeat head CT scan Prognosis Health-related quality of life 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

The study is consistent with the principles of the Declaration of Helsinki of clinical research involving human subjects.

Informed consent

All patients gave their informed consent.

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Copyright information

© SIMI 2016

Authors and Affiliations

  • Francesca Innocenti
    • 1
    Email author
  • Beatrice Del Taglia
    • 1
  • Irene Tassinari
    • 1
  • Federica Trausi
    • 1
  • Alberto Conti
    • 1
  • Maurizio Zanobetti
    • 1
  • Riccardo Pini
    • 1
  1. 1.High-Dependency Unit, Department of Clinical and Experimental MedicineAzienda Ospedaliero-Universitaria CareggiFlorenceItaly

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