Fabian Finkelmeier, Sophie Walter, Kai-Henrik Peiffer, Anjali Cremer, Andrea Tal, Thomas J. Vogl, Stefan Zeuzem, Stephan Fichtlscherer, Mireen Friedrich-Rust, Jörg Bojunga, Harald Farnik
- 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.
MetadatenVerfasserangaben: | Fabian FinkelmeierORCiDGND, Sophie Walter, Kai-Henrik PeifferORCiDGND, Anjali CremerORCiD, Andrea Tal, Thomas J. VoglORCiDGND, Stefan ZeuzemORCiDGND, Stephan Fichtlscherer, Mireen Friedrich-RustORCiDGND, Jörg BojungaGND, Harald FarnikGND |
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URN: | urn:nbn:de:hebis:30:3-534274 |
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DOI: | https://doi.org/10.1177/0885066617720901 |
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ISSN: | 1525-1489 |
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ISSN: | 0885-0666 |
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Titel des übergeordneten Werkes (Englisch): | Journal of intensive care medicine |
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Verlag: | SAGE Publications |
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Verlagsort: | London [u. a.] |
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Dokumentart: | Wissenschaftlicher Artikel |
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Sprache: | Englisch |
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Jahr der Fertigstellung: | 2019 |
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Datum der Erstveröffentlichung: | 18.07.2017 |
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Veröffentlichende Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Datum der Freischaltung: | 01.05.2020 |
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Freies Schlagwort / Tag: | CT; computed tomography; critical care unit; critical ill patients; sepsis |
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Jahrgang: | 34 |
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Ausgabe / Heft: | 11-12 |
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Seitenzahl: | 12 |
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Erste Seite: | 955 |
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Letzte Seite: | 966 |
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HeBIS-PPN: | 465981283 |
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Institute: | Medizin / Medizin |
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DDC-Klassifikation: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Lizenz (Deutsch): | Deutsches Urheberrecht |
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