A decision rule with 7 clinical criteria identified patients with minor head injury who did not need computed tomography
2001
(2000) N Engl J Med 343, 100. Haydel MJ, Preston CA, Mills TJ, et al. . Indications for computed tomography in patients with minor head injury. . Jul 13; . : . –5 .
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QUESTION: In patients with minor head injury, can a clinical decision rule using 7 clinical criteria identify those patients who do not need computed tomography (CT)?
2 cohort studies, one for derivation and one for validation of the clinical criteria.
A large, inner city, level 1 trauma centre in New Orleans, Louisiana, USA.
Consecutive patients with minor head injury (loss of consciousness with normal findings on a brief neurological examination and a score of 15 on the Glasgow Coma Scale) in 2 phases (520 in the derivation set, 909 in the validation set, each with mean age 36 y, 65% men). Inclusion criteria were age ≥3 years and presentation <24 hours after injury.
Prognostic clinical criteria recorded before CT in the derivation set were age and presence of headache, vomiting, drug or alcohol intoxication, short term antegrade memory deficits, seizure, history of coagulopathy, and physical evidence of trauma above the clavicles. For the validation set, the same criteria, excluding history of coagulopathy, were recorded before CT. Patients were …
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