Background: There continues to be an ongoing debate regarding the utility of head CT scans in Patients with a normal Glasgow Coma Scale (GCS) after minor head injury. The objective of this study is to determine Patient and injury characteristics that predict a positive head CT scan or need for a neurosurgical procedure (NSP) among Patients with blunt head injury and a normal GCS.
Materials and methods: Retrospective analysis of adult Patients in the National Trauma Data Bank who presented to the ED with a history of blunt head injury and a normal GCS of 15. The primary outcomes were a positive head CT scan or a NSP. Multivariate logistic regression controlling for Patient and injury characteristics was used to determine predictors of each outcome.
Results: Out of a total of 83,566 Patients, 24,414 (29.2%) had a positive head CT scan and 3476 (4.2%) underwent a NSP. Older Patients and Patients with a history of fall (compared with a motor vehicle crash) were more likely to have a positive finding on a head CT scan. Male Patients, African-Americans (compared with Caucasians), and those who presented with a fall were more likely to have a NSP. Conclusions: Older age, male gender, ethnicity, and mechanism of injury are significant predictors of a positive finding on head CT scans and the need for neurosurgical procedures. This study highlights Patient and injury-specific characteristics that may help in identifying Patients with supposedly minor head injury who will benefit from a head CT scan.