title: Urgent computed tomography brain scan for elderly patients:  can we improve its diagnostic yield?
abstract: We conducted a retrospective study of 291 patients aged 75 years or older who were admitted to the emergency department and who underwent a computed tomography (CT) brain scan. Our aims were to assess the reasons for requesting an urgent CT brain scan, to record the diagnostic yield of cerebral imaging, and to seek out predictive factors of an intracranial pathology. The three main reasons for requesting an urgent CT brain scan were the presence of localizing signs (60%), delirium (21%), and disorders of consciousness with a Glasgow Coma Score of less than 14 (14.5%). In our elderly population, we found no typical patient profile when concerned with the risk of having an intracranial pathology. The multivariate logistic regression found that predictive factors for intracranial bleeding were localizing signs, disorders of consciousness with a Glasgow Coma Score of less than 14, head trauma, sudden-onset headache, or headache associated with at least two episodes of vomiting.
authors.affiliation: Emergency Department, University Hospital Hotel Dieu of Nantes, Nantes, France. segard.julien@gmail.com
authors.forename: Julien
authors.initials: J
authors.lastname: Segard
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Montassier
authors.forename: David
authors.initials: D
authors.lastname: Trewick
authors.forename: Philippe
authors.initials: P
authors.lastname: Le Conte
authors.forename: Benoit
authors.initials: B
authors.lastname: Guillon
authors.forename: Gilles
authors.initials: G
authors.lastname: Berrut
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D001927:Brain Diseases / Q000175:diagnosis*; D001930:Brain Injuries / Q000000981:diagnostic imaging; D002543:Cerebral Hemorrhage / Q000175:diagnosis; D003693:Delirium / Q000175:diagnosis; D004632:Emergency Medical Services; D015600:Glasgow Coma Scale; D006801:Humans; D016015:Logistic Models; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*