title: Results of delayed follow-up imaging in traumatic brain injury.
abstract: OBJECTIVE
  There is a paucity of scientific evidence available about the benefits of outpatient follow-up imaging for traumatic brain injury patients. In this study, 1 year of consecutive patients at a Level 1 trauma center were analyzed to determine if there is any benefit to routinely obtaining CT of the head at the outpatient follow-up visit.
  
  
  METHODS
  This single-institution retrospective review was performed on all patients with a traumatic brain injury seen at a Level 1 trauma center in 2013. Demographic data, types of injuries, surgical interventions, radiographic imaging in inpatient and outpatient settings, and outcomes were assessed through a review of the institution's trauma registry, patient charts, and imaging.
  
  
  RESULTS
  Five hundred twenty-five patients were seen for traumatic brain injury in 2013 at Regional One Health in Memphis, Tennessee. One hundred eighty-five patients (35%) presented for outpatient follow-up, all with CT scans of the head. Seven of these patients (4%) showed worsening of their intracranial injuries on outpatient imaging studies; however, surgical intervention was recommended for only 3 of these patients (2%). All patients requiring an intervention had neurological deterioration prior to their follow-up appointment.
  
  
  CONCLUSIONS
  These experiences suggest that outpatient follow-up imaging for traumatic brain injury should be done selectively, as it was not helpful for patients who did not exhibit worsening of neurological signs or symptoms. Furthermore, routine outpatient imaging results in unnecessary resource utilization and radiation exposure.
authors.affiliation: Department of Neurosurgery, University of Tennessee Health Science Center; and.
authors.forename: Adam Ross
authors.initials: AR
authors.lastname: Befeler
authors.affiliation: Department of Neurosurgery, University of Tennessee Health Science Center; and.
authors.forename: William
authors.initials: W
authors.lastname: Gordon
authors.affiliation: Department of Neurosurgery, University of Tennessee Health Science Center; and.
authors.forename: Nickalus
authors.initials: N
authors.lastname: Khan
authors.affiliation: Department of Neurosurgery, University of Tennessee Health Science Center; and.|Semmes-Murphey Neurological and Spine Institute, Memphis, Tennessee.
authors.forename: Julius
authors.initials: J
authors.lastname: Fernandez
authors.affiliation: Department of Neurosurgery, University of Tennessee Health Science Center; and.|Semmes-Murphey Neurological and Spine Institute, Memphis, Tennessee.
authors.forename: Michael Scott
authors.initials: MS
authors.lastname: Muhlbauer
authors.affiliation: Department of Neurosurgery, University of Tennessee Health Science Center; and.|Semmes-Murphey Neurological and Spine Institute, Memphis, Tennessee.
authors.forename: Jeffrey Marius
authors.initials: JM
authors.lastname: Sorenson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D015982:Bias; D001930:Brain Injuries / Q000150:complications* / Q000000981:diagnostic imaging* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers; D055815:Young Adult
keywords: GCS = Glasgow Coma Scale; ROH = Region One Health; TBI = traumatic brain injury; delayed imaging; head injury; outpatient imaging; trauma; traumatic brain injury