Can Mild Traumatic Brain Injury Risk Score (MTBI risk score) Predict for Positive CT Brain Result in High Risk of Mild Head Injury Patients?
Keywords:
Mild TBI, Brain CT scanAbstract
Backgrounds: The most common presentation of traumatic brain injury in Emergency Department is mild traumatic brain injury (Mild TBI). Brain CT scan is not necessary in all mild TBI patient.
Objective: To investigate the impact of risk factors involving brain abnormalities on CT scan, and document the effectiveness of MTBI risk score to used in mild TBI.
Methodology: Retrospective data from medical records and divided patients into 2 groups; those with abnomal brain CT results and those without brain CT abnormalities. Then, analyzing the risk factors and conditions of these two groups in order to indicate the risk factors related to an abnormality in the brain.
Result: Total numbers of patients were 350 persons, comprise of 89 persons with abnormal brain CT (25.43%) and 261 persons without brain abnormalitkes (74.57%). The result showed only 13 risk factors that have the important effect on brain abnormalities. Throughout the multivariate analysis, there was a clearly result indicate that only 7 risk factors significantly caused the abnormalities of brain. Form these 7 risk factors, we formulated for MTBI risk score. Each risk factors (Clinical sign of skull fracture, multi-system trauma with GCS 13-14, history of loss of conciousness, dangerous mechanism, post traumatic amnesia, GCS 13-14) was given 1 point except for focal neurological signs that given 2 points. Patient with MTBI risk score greater or equal to 1 point suggested to be evaluated by CT scan. The sensitivity and specificity of MTBI risk score were 92.13% and 34.10%.
Conclusion: MTBI risk score may be used in mild TBI patients to indication for brain CT scan.
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