Potentially inappropriate brain CT-scan requesting in the emergency department: A retrospective study in patients with neurologic complaints

Hossein Alimohammadi; Shima Zareh Shahamati; Abdolazim Karkhaneh Yousefi; Behnam Safarpour Lima

doi:10.23750/abm.v92i5.10209

Potentially inappropriate brain CT-scan requesting in the emergency department: A retrospective study in patients with neurologic complaints

Authors

Hossein Alimohammadi Associated professor of emergency medicine, Department of Emergency, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Shima Zareh Shahamati Neurology resident, Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abdolazim Karkhaneh Yousefi Emergency medicine graduated researcher, Department of Emergency, Shahid Beheshti University of Medical sciences, Tehran, Iran
Behnam Safarpour Lima a:1:{s:5:"en_US";s:119:"Assistant professor of Neurology, Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran";}

DOI: https://doi.org/10.23750/abm.v92i5.10209

Keywords:

Brain CT-scan, Emergency, Neurology

Abstract

Background: Potentially inappropriate brain CT scan requesting in the emergency department imposes extra charges to the healthcare system and patients. Besides, the unnecessary radiation exposure may cause irreparable damage to the patient. In this study we investigated the percentage of potentially inappropriately conducted brain CT scan for different chief complaints in non-traumatic patients presented to our emergency department.

Material and methods: 160 patients aged over 18 years old with chief complaints other than trauma, referred to the emergency department of Imam Hossein Hospital (Tehran, Iran), were enrolled in this study. Data were collected from medical records; the inclusion criteria was patients older than 18 years with chief complaint other than trauma.

Results: 160 people aged 18 to 100 years old enrolled in this study, 83 (51.87%) were male and 77 (48.13%) were female. There was no statistically significant difference in terms of potentially inappropriate brain CT between different age groups. Percentage of potentially inappropriate CT according to chief complaints were as follows: 4.8% for dysarthria, 0% for right and left hemiplegia, 9.1% for decreased level of consciousness, 30% for nausea and vomiting, 41.7% for generalized weaknesses, 0% for seizures, 55.6% for vertigo, 25% for headache, and 57.7% for other complaints. There was a statistically significant association between chief complaints and potentially inappropriate brain CT scan requests (p-value = 0.001).

Conclusion: Considering the significant percentage of potentially inappropriate brain CT scan requests for non-traumatic patients in the setting of emergency department, it is critical for healthcare policymakers to propose practical guidelines and supervise their application.

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