Compatibility of Brain CT_Scans with valid guidelines criteria in mild traumatic brain injury patients in emergency department of Madani medical education Center in Karaj

Brain injury is a prevalent problem in emergency department. Assessing traumatic brain injury (TBI) usually needs imaging, of them Computed Tomography scanning (CT scan) is very useful for detecting brain pathology in these patients. On the other hand in mild TBI patients, CT imaging may be used without indication which leads to overuse and unnecessary harm to patients and also waste of resources. Due to the lack of data in Iran, the study aimed to assess the compatibility of Brain CT Scans with valid guidelines criteria in mild traumatic brain injury patients in emergency department of Madani medical education center in Karaj.

A cross-sectional design study were used to assess compatibility of CT scans with different guidelines. A convenient sample of patients with mild TBI who referred to the emergency department of Madani medical education center and had underwent CT scan, entered the study. Patients with other accompanying injuries excluded from the study. Demographic data, mechanism of injury, signs and symptoms of patients were gathered using a check list. Indications for doing CT scans in adults were checked using Neworleans and Canadian guidelines. PECARN guideline also used for children. Data analyzed using SPSS software.

267 patients with the mean age of 35.13 (±22.502) years were evaluated. 168 (62.9%) patients were male and 99 (37.1%) were female. 35 (13.1%) patients according to PECARN+Neworleans guidelines and 127 (47.6%) patients according to PECARN+Canadian guidelines did not have any indication. Only 14 (5.2%) patients had abnormal CT findings. All of them had indications of performing CT scan. It could be estimated that 43 or 157 thousand brain CT scan are performed without indication, which result in wasting more than 23 or 84 billion rials of health system budget.

The results of this study indicate the use of valid guideline criteria reduce unnecessary brain CTs, thus preventing the loss of cost, time, manpower and depreciation of devices and also causes reduction of disease caused by the complication of CT scan radiation.