Patient selection for skull radiography in uncomplicated head injury.
The costs and benefits of six different patient-selection guidelines for skull radiography are presented. The study is based on data from a national study involving 4829 patients with uncomplicated head injury who underwent skull radiography in nine accident and emergency units throughout the U.K. With the most conservative guideline 94% of patients with vault fractures and all those in whom outcome was serious (depressed, basal, or frontal fracture, intracranial haematoma, aerocele, or death) would be X-rayed, at a saving of 21 . 3% on radiological costs incurred by current practice. At the other extreme is a guideline which embraced 58 . 2% of patients with vault fractures and 85% of patients with serious outcome, at a saving of 72 . 9%. The range of guidelines permits the reader to explore his own preference and become aware of the implications of his choice.
D003362:Cost-Benefit Analysis; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging*; D006801:Humans; D011859:Radiography / Q000191:economics*; D012306:Risk; D012886:Skull / Q000000981:diagnostic imaging*; D012887:Skull Fractures / Q000000981:diagnostic imaging*; D006113:United Kingdom