title: Head computed tomography utilization and intracranial hemorrhage rates.
abstract: Utilization of computed tomography scans (CTs) has increased dramatically in emergency departments in the USA. This study aimed to retrospectively determine the yield of CTs among all patients that received a CT of the head from 2001 to 2007, which is adjusted for patient volume. For secondary endpoints, we examined the yield of CT of the head for the following hemorrhages: (1) intracerebral, (2) subarachnoid, (3) subdural, and (4) epidural. In 2001, 3.3 head CTs were performed per 100 patients seen. This increased by 60 % to 5.2 per 100 in 2007 (p = 0.005, R (2) = 0.82). This correlated with a nonsignificant decrease in the rate of intracranial hemorrhage found by CT from 3.6 per 100 CTs in 2001 (95 % confidence interval (CI) = 2.7-4.5) to 3.0 per 100 in 2007 (95 % CI = 2.5-3.6). There were no significant differences in "positive" rates for each subgroup of intracranial hemorrhage. Our study found that the utilization of head CTs increased dramatically, but there was a corresponding increase in the number of positive findings so that the overall yield of head CTs from 2001 to 2007 remained relatively constant.
authors.affiliation: Trauma, Emergency Surgery, Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge St, Suite 810, Boston, MA 02114, USA. lee.jarone@mgh.harvard.edu
authors.forename: Jarone
authors.initials: J
authors.lastname: Lee
authors.forename: C Scott
authors.initials: CS
authors.lastname: Evans
authors.forename: Neil
authors.initials: N
authors.lastname: Singh
authors.forename: Jonathan
authors.initials: J
authors.lastname: Kirschner
authors.forename: Daniel
authors.initials: D
authors.lastname: Runde
authors.forename: David
authors.initials: D
authors.lastname: Newman
authors.forename: Dan
authors.initials: D
authors.lastname: Wiener
authors.forename: Josh
authors.initials: J
authors.lastname: Quaas
authors.forename: Kaushal
authors.initials: K
authors.lastname: Shah
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology*; D004636:Emergency Service, Hospital; D005260:Female; D006257:Head / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*