Follow-up head CT in elderly trauma patients can detect new hemorrhages

Routine follow-up CT imaging in elderly patients who have experienced head trauma may need to be implemented into standardized treatment plans at a more cost-effective rate, according to a recent article by JACR.  

University of Arkansas for Medical Sciences researchers have examined the benefit that a six-hour repeat head CT for elderly trauma patients can have along with standard follow-up procedures.  

"We sought to better understand the exact rates of interval positive findings at our institution after initially negative head CTs in elderly patients on anticoagulation therapy; previously published material revealed mixed outcomes and opinions," said lead author of the study Bennett Battle, MD.  

Researchers conducted follow-up CT scans of 110 trauma patients who initially had a negative non-contrast head CT. Their results showed that only two patients (1.8 percent) had any signs of hemorrhages, and neither required a change in care management other than further observation. Nonetheless, Battle and his team advise that a routine follow-up CT should not justify a change in mental state or the development of new cranial or physical symptoms.  

Further motivation for this study comes from a financial angle, as well. According to the study, the ACR has estimated that the cost to the patient for a head CT is approximately $400.  

"As such, head imaging represents a substantial monetary burden to patients and the health care system in general," Battle said. "A more clinically tailored approach to repeat head imaging has the potential to both more effectively alter treatment while also saving money."