Is it really needed to obtain control head computerized tomography in patients with blunt head trauma in emergency department?

Introduction and Aim: As it contains high risk in terms of potential death and complications, the head trauma has an importat share in the emergency departments in the point of both economical and medical aspect. In the present study our aim is to determine whether the control head computed tomoghraphy (CT) scans of the blunt head trauma patients of Dokuz Eylül University Hospital Adult Emergency Department utilize clinically or not. Methods and Material: Two years back-word looking analysis of the patients who have blunt head trauma and whose first and control head CT scans are got in DEU Hospital emergency department have been done. The patients, that are classified into two groups by whether they have abnormal radiolagical findings in their first head CT scans or not, have been classified into two new groups as well by whether they have new lesion in their control head CT scans and/or have progression or they do have no new lesion and/or have remission. For any patient from any group the changes in the clinical data and neurological and radiolagical findings are inscribed into the data form. Result: 396 patients have been considered in this study. Falls are the leading cause of the head trauma (%40.4). Patients with mild head trauma is the most crowded group (%90.4). It is obtained that there is a meaningful relationship between the increase of the severity of the head trauma and having abnormal finding in first head CT scan. The leading comorbidity is face trauma (,%43,4). There were abnormal findings in the first head CT scan for 208 patients (%52.5). Almost the half of these abnormalities were subarachnoid hemorrhage (%47.8). It is obtained that a meaningful relationship between the existence of abnormal finding and age over 65, comorbidity, high arrival aPT level with high aPTT level. It is also achived that avarage time of having the head CT scan is 9 hours and 33 minutes and this time has a meaningful relationship between changes in findings. There are 20 new lesions/progressions in control head CT scan that do not exist in the first one. However, any relationship between these new lesions and a spesific traumatiation could not be obtained. After getting control head CT scan, %61 of the patients discharged from the department. About 35% of the patients was hospitalized in DEU Hospital. While %1,5 of the patients died in the emergency department, the ratio of the patients who were transferred to other hospitals was %2,5. Conclusion: According to this study it is concluded that control head CT scan for a patient with blunt head trauma is demanded without considering the changes in the neurological abnormalities and there is no meaningful relationship between the first head CT scans of the patients and clinical outcomes.