Citation

Akre KAT, Ingebrigtsen T. Tidsskr. Nor. Laegeforen. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Norske Laegeforening)

DOI

10.4045/tidsskr.20.0986

PMID

unavailable

Abstract

BACKGROUND: The Scandinavian guidelines for initial management of minimal, mild and moderate head injuries in adults aim to identify patients at risk of developing intracranial haematoma, while also avoiding unnecessary computed tomography (CT) scans and hospital admissions. We examined compliance with the guidelines at the University Hospital of North Norway, Tromsø. MATERIAL AND METHOD: A search in the patient administration system identified 448 patients with a diagnosis code for head injury. We excluded 298 who met one or more exclusion criteria, and included 150 with minimal, mild or moderate injuries in a retrospective study. Management was categorised as being either compliant or non-compliant with the guidelines. We defined non-compliance as overtesting (unnecessary CT scan and/or hospital admission) or undertesting (omission of necessary CT scan and/or hospital admission).

RESULTS: Management was in accordance with the guidelines for 96/150 (64 %) patients. This proportion increased with the severity of the injury (minimal 4/12 (33 %), mild 76/119 (64 %) and moderate 16/19 (84 %)). A total of 54/150 (36 %) patients were not managed in accordance with the guidelines. This was due to unnecessary CT scans and/or hospitalisation in 39/54 (72 %) patients and undertesting in 15/54 (28 %). Among patients with low-risk mild head injuries, 35/57 (61 %) underwent analysis of the brain injury marker S100B, as per the recommendations.

INTERPRETATION: Compliance with the Scandinavian guidelines could be improved.

Language: en