Pattern and Predictors of positive head computed tomography scan in mild traumatic brain injury.

Abstract

Abstract Background: - Mild TBI (traumatic brain injury) is one of the commonest causes of ED (emergency department) presentation. However, the use of head CT (computed tomography) scan for mild TBI is not justified properly and is an area of controversy for quite a long time. Objective: - To analyse the patterns of positive head CT findings in patients with mild TBI and investigate the predictors of positive CT scan in mild TBI at AaBET hospital from April 15, 2022 to July 15, 2022. Methodology: - A cross-sectional institution-based study was conducted at AaBET hospital, Addis Ababa, Ethiopia. The study included 407 patients presented to the emergency department with a diagnosis of mild TBI who underwent a head CT scan during a study period of April 15,2022 to July 15, 2022. Exhaustive sampling technique was used to get the required sample size. Data was collected by structured questionnaire from patient’s chart trauma registry and analysed by SPSS vesion25.0. To know the association factor between dependent (prevalence and pattern of positive head CT) and independent variable binary logistic regression and multivariate logistic regression was done and p value < 0.05 at 95% CI was declared statistically significant association. Result: - Out of 407 patients included in the study, majority of trauma cases sustained RTA 40.5%. Linear skull fracture was observed in 33.6%. Male patients 7.874 times [AOR= 7.874, 95% CI (1.886, 32.884)] more likely have positive CT scan than female patients. Patients arrive at ED within 7 - 24hr were 4.913 times [AOR= 4.913, 95% CI (1.99,12.117)] more likely have positive CT scan result than a patient arrive within 6 hrs of arrival to the ED. Patients with unknown duration of LOC were 67.931 times [AOD=67.93,95% CI (3.67,1255.8)] more likely to have positive CT scan than patients with less than 5 minutes of LOC. Patients having ear/nose CSF leak and Vomiting were more likely to have a positive CT scan than those who didn’t have those. Conclusion: - Road traffic accidents were the major cause of trauma in which pedestrians were affected more. Sex, duration of time to arrive at the ED, presence of LOC, vomiting and ear/nose CSF leak are the designated variables predicting positive head CT scan in patients who sustained mild TBI. Keywords: - prevalence, Pattern, predictor, mild TBI, positive CT