TY  - JOUR
PY  - 2018//
TI  - Neurocognitive assessment in patients with a minor traumatic brain injury and an abnormal initial CT scan: can cognitive evaluation assist in identifying patients who require surveillance CT brain imaging?
JO  - American journal of surgery
A1  - Clements, Thomas W.
A1  - Dunham, Michael
A1  - Kirkpatrick, Andrew
A1  - Rajakumar, Ruphus
A1  - Gratton, Carolyn
A1  - Lall, Rohan
A1  - McBeth, Paul
A1  - Ball, Chad G.
SP  - 843
EP  - 846
VL  - 215
IS  - 5
N2  - BACKGROUND: Evidence for repeat computed tomography (CT) in minor traumatic brain injury (mTBI) patients with intracranial pathology is scarce. The aim of this study was to investigate the utility of clinical cognitive assessment (COG) in defining the need for repeat imaging. <br><br>METHODS: COG performance was compared with findings on subsequent CT, and need for neurosurgery in mTBI patients (GCS 13-15 and positive CT findings). <br><br>RESULTS: Of 152 patients, 65.8% received a COG (53.0% passed). Patients with passed COG underwent fewer repeat CT (43.4% vs. 78.7%; p = .001) and had shorter LOS (8.7 vs. 19.5; p < .05). Only 1 patient required neurosurgery after a passed COG. The negative predictive value of a normal COG was 90.6% (95%CI = 81.8%-95.4%). <br><br>CONCLUSION: mTBI patients with an abnormal index CT who pass COG are less likely to undergo repeat CT head, and rarely require neurosurgery. The COG warrants further investigation to determine its role in omitting repeat head CT.<br><br>Copyright © 2018 Elsevier Inc. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-9610
UR  - http://dx.doi.org/10.1016/j.amjsurg.2017.11.046
ID  - ref1
ER  -