TY  - JOUR
A1  - Finkelmeier, Fabian
A1  - Walter, Sophie
A1  - Peiffer, Kai-Henrik
A1  - Cremer, Anjali
A1  - Tal, Andrea
A1  - Vogl, Thomas J.
A1  - Zeuzem, Stefan
A1  - Fichtlscherer, Stephan
A1  - Friedrich-Rust, Mireen
A1  - Bojunga, Jörg
A1  - Farnik, Harald
T1  - Diagnostic yield and outcomes of computed tomography of the head in critically ill nontrauma patients
T2  - Journal of intensive care medicine
N2  - Background: Computed tomography of the head (HCT) is a widely used diagnostic tool, especially for emergency and trauma patients. However, the diagnostic yield and outcomes of HCT for patients on medical intensive care units (MICUs) are largely unknown.
Methods: We retrospectively evaluated all head CTs from patients admitted to a single-center MICU during a 5-year period for CT indications, diagnostic yield, and therapeutic consequences. Uni- and multivariate analyses for the evaluation of risk factors for positive head CT were conducted.
Results: Six hundred ninety (18.8%) of all patients during a 5-year period underwent HCT; 78.7% had negative CT results, while 21.3% of all patients had at least 1 new pathological finding. The main indication for acquiring CT scan of the head was an altered mental state (AMS) in 23.5%, followed by a new focal neurology in 20.7% and an inadequate wake up after stopping sedation in 14.9% of all patients. The most common new finding was intracerebral bleeding in 6.4%. In 6.7%, the CT scan itself led to a change of therapy of any kind. Admission after resuscitation or a new focal neurology were independent predictors of a positive CT. Psychic alteration and AMS were both independent predictors of a higher chance of a negative head CT. Positive HCT during MICU is an independent predictor of lower survival.
Conclusions: New onset of focal neurologic deficit seems to be a good predictor for a positive CT, while AMS and psychic alterations seem to be very poor predictors. A positive head CT is an independent predictor of death for MICU patients.
KW  - computed tomography
KW  - CT
KW  - critical ill patients
KW  - critical care unit
KW  - sepsis
Y1  - 2017
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/53427
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-534274
SN  - 1525-1489
SN  - 0885-0666
VL  - 34
IS  - 11-12
SP  - 955
EP  - 966
PB  - SAGE Publications
CY  - London [u. a.]
ER  -