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Open Access

Routine repeat head CT may not be necessary for patients with mild TBI

Claire B Rosen, Diego D Luy, Molly R Deane, Thomas M Scalea, Deborah M Stein
DOI: 10.1136/tsaco-2017-000129 Published 30 January 2018
Claire B Rosen
1 Department of Surgery, University of Maryland School of Medicine, University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA
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Diego D Luy
2 Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Molly R Deane
3 Los Angeles County Harbor-UCLA Medical Center, Department of Surgery, Torrance, California, USA
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Thomas M Scalea
1 Department of Surgery, University of Maryland School of Medicine, University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA
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Deborah M Stein
1 Department of Surgery, University of Maryland School of Medicine, University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA
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    Figure 1

    Intervention groups.

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  • Table 1

    Population demographics

    Patients, n85
    Age, mean±SD64±20
    Gender M (%)/F(%)60 (71%)/25 (29%)
    Race W (%)/B (%)/O (%)63 (74%)/17 (20%)/5 (6%)
    BMI, mean±SD (kg/m2)27±6
    Mechanism of injury
     Motor vehicle collision, n (%)18 (21%)
     Gunshot wound, n (%)1 (1%)
     Fall, n (%)49 (58%)
     Other, n (%)17 (20%)
    Mechanism of trauma
     Blunt, n (%)82 (96%)
     Penetrating, n (%)3 (4%)
    GCS at admission14.6±0.57
    LOS, mean±SD (days)6.3±8.1
    Mortality, n (%)0 (0%)
    • B, black; BMI, body mass index; F, female; GCS, Glasgow Coma Scale; LOS, length of stay; M, male; O, others; W, white.

  • Table 2

    Demographics by intervention

    No interventionSurgical interventionP value
    Age, mean±SD62.2±20.767.5±16.90.27
    Male, n (%)55 (73%)4 (67%)0.37
    Female, n (%)20 (27%)2 (33%)
    Black, n (%)14 (19%)2 (33%)
    White, n (%)55 (73%)4 (67%)0.38
    Other, n (%)6 (8%)0 (0%)
    Body mass index, mean±SD26.6±5.5728.2±10.50.37
  • Table 3

    Initial injury classification by intervention

    No interventionSurgical interventionP value
    AIS brain3.4±0.64.8±0.3<0.001
     Patients, n756
    SDH size (cm)0.49±0.31.1±0.60.05
     Patients with SDH, n295
    Midline shift (cm)0.49±0.50.56±0.40.38
     Patients with midline shift, n65
    • AIS, Abbreviated Injury Scale; SDH, subdural hematoma.

  • Table 4

    Initial Glasgow Coma Scale (GCS) change by intervention group

    Initial GCSHour 6 GCSHour 24 GCS
    No intervention (75 patients)14.614.614.6
    Surgical intervention (6 patients)1513.113
    Δ 0–6 hours Δ 6–24 hours Δ 0–24 hours
    No intervention (75 patients)0.06±0.47−0.01± 0.82 0.06±0.86
    Surgical intervention (6 patients)−1.8±2.7−0.12±2−2±3
    P value0.090.440.09
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Routine repeat head CT may not be necessary for patients with mild TBI
Claire B Rosen, Diego D Luy, Molly R Deane, Thomas M Scalea, Deborah M Stein
Trauma Surg Acute Care Open Jan 2018, 3 (1) e000129; DOI: 10.1136/tsaco-2017-000129

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Routine repeat head CT may not be necessary for patients with mild TBI
Claire B Rosen, Diego D Luy, Molly R Deane, Thomas M Scalea, Deborah M Stein
Trauma Surg Acute Care Open Jan 2018, 3 (1) e000129; DOI: 10.1136/tsaco-2017-000129
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Routine repeat head CT may not be necessary for patients with mild TBI
Claire B Rosen, Diego D Luy, Molly R Deane, Thomas M Scalea, Deborah M Stein
Trauma Surgery & Acute Care Open Jan 2018, 3 (1) e000129; DOI: 10.1136/tsaco-2017-000129
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