Emergency CT for head trauma may be overused

New research suggests emergency patients are often given unwarranted CT scans to check for skull fractures and brain hemorrhage, resulting in wasted healthcare dollars and increasing exposure to radiation, according to an American Roentgen Ray Society (ARRS) press release.

The study is set to be presented by Michaela Cellina, with the radiology department of Fatebenefratelli-Sacco Hospital in Italy, at the ARRS 2018 Annual Meeting April 22 to 27 in Washington, D.C.

In the study, the team evaluated head CT scans performed for minor head injury in patients aged 18 to 45 years old, who presented to the hospital’s emergency department between Jan. 1 and June 30, 2016. Researchers determined whether CT scans met the criteria indicated by either the National Institute for Health and Care Excellence (NICE) and the Canadian CT Head Rule (CCHR).

Th study included 492 cases—260 were not indicated according to NICE and 376 did not meet CCHR requirements. The team noted no statistically significant difference between the specialty and seniority of the referring physician and over-referral. However, motor vehicle accidents were connected to a higher rate of non-indicated CT exams for both NICE and CCHR, and two-wheel vehicle driver accidents were associated with a higher rate of appropriated CT exams for both NICE and CCHR.

Only 15 of the 260 CT exams were positive for brain hemorrhage, subarachnoid hemorrhage or skull fracture, according to the release.