The Applicability Of Head CT Rules On The Chinese Patients With Mild Traumatic Brain Injury

Objective:Computed tomography(CT)provides the primary diagnostic evidence for traumatic brain injury(TBI),but few positive traumatic findings are discovered in patients with mild TBI.In China,there are no existing criteria for selecting patients with mild TBI to undergo CT,and almost all of these patients undergo cranial CT in the emergency department.Our study tries to validate Canadian CT head rule(CCHR)and New Orleans Criteria(NOC)in the Chinese patients to reduce the unnecessary use of cranial CT.Methods:This retrospective study was performed in the First Affiliated Hospital,College of Medicine,Zhejiang University.Patients with mild TBI who underwent cranial CT within 24 h of the trauma were included,and their medical information was reviewed.Two neurosurgeons reviewed the CT images independently to identify positive CT findings.The sensitivity and specificity of the Canadian CT head rule(CCHR)and New Orleans Criteria(NOC)for positive CT findings related to TBI were analyzed.Results:This study included 625 patients.Positive CT findings related to TBI were discovered in 13.12%(82/625)of these patients on cranial CT,and 6.88%(43/625)of them were admitted to the hospital for further management.Ultimately,11 patients(1.76%,11/625)underwent neurosurgery.In this study,the sensitivities of the CCHR and NOC were both 100%,but the specificity of CCHR was 43.36%and that of NOC was 33.12%.Conclusion:Both CCHR and NOC have high sensitivity for the detection of positive CT findings related to head trauma in patients with mild TBI.Both sets of criteria are suitable for Chinese patients.