A second look at the utility of serial routine repeat computed tomographic scans in patients with traumatic brain injury.
BACKGROUND
The practice of a routine repeat head computed tomographic scans in patients with traumatic brain injury (TBI) is under question. The aim of our study was to evaluate the utility of a more than 1 repeat head computed tomography (M1CT) scans in patients with TBI.


METHODS
We performed a 3-year analysis of a prospectively collected database of all TBI patients presenting to our level I trauma center. Patients who received M1CT scans were included. Findings and reason (without neurologic decline vs after neurologic decline) for M1CT were recorded. Primary outcome measure was neurosurgical intervention.


RESULTS
A total of 296 patients that underwent M1CT were included. Of those, 291 patients (98.6%) had M1CT without a neurologic decline, and neurosurgical intervention was performed in 1 patient (.3%) who was inexaminable (Glasgow coma scale score = 6). The remaining (n = 5) had M1CT due to a neurologic decline; 4 patients (80%) of the 5 had worsening of ICH; and neurosurgical intervention was performed in 3 (75%) of the 4 patients.


CONCLUSIONS
The practice of multiple repeat head computed tomographic scans should be limited to inexaminable patients or patients with neurological deterioration.
Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, 501 North Campbell Avenue, Room 5411, PO Box 245063, Tucson, AZ, 85724, USA.
Ansab A
AA
Haider
Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, 501 North Campbell Avenue, Room 5411, PO Box 245063, Tucson, AZ, 85724, USA.
Peter
P
Rhee
Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, 501 North Campbell Avenue, Room 5411, PO Box 245063, Tucson, AZ, 85724, USA.
Tahereh
T
Orouji
Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, 501 North Campbell Avenue, Room 5411, PO Box 245063, Tucson, AZ, 85724, USA.
Narong
N
Kulvatunyou
Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, 501 North Campbell Avenue, Room 5411, PO Box 245063, Tucson, AZ, 85724, USA.
Tania
T
Hassanzadeh
Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, 501 North Campbell Avenue, Room 5411, PO Box 245063, Tucson, AZ, 85724, USA.
Andrew
A
Tang
Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, 501 North Campbell Avenue, Room 5411, PO Box 245063, Tucson, AZ, 85724, USA.
Adil
A
Farman
Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, 501 North Campbell Avenue, Room 5411, PO Box 245063, Tucson, AZ, 85724, USA.
Terence
T
O'Keeffe
Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, 501 North Campbell Avenue, Room 5411, PO Box 245063, Tucson, AZ, 85724, USA.
Rifat
R
Latifi
Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, 501 North Campbell Avenue, Room 5411, PO Box 245063, Tucson, AZ, 85724, USA. Electronic address: bjoseph@surgery.arizona.edu.
Bellal
B
Joseph
D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000601:surgery; D018450:Disease Progression; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014193:Trauma Centers
More than 1 repeat scans; Neurologic decline; Neurosurgical intervention; Radiological progression; Serial CT scans; Traumatic brain injury