Predictors of abnormal brain computed tomography findings in patients with acute altered mental status in the emergency department
Clinical and Experimental Emergency Medicine
;
(4): 1-6, 2018.
Article
in English
| WPRIM
| ID: wpr-713326
ABSTRACT
OBJECTIVE:
Brain computed tomography (CT) is commonly performed to diagnose acute altered mental status (AMS), a critically important symptom in many serious diseases. However, negative CT results are common, which result in unnecessary CT use. Therefore, this study aimed to determine the clinical factors associated with positive CT findings.METHODS:
Patients with acute AMS selected from an emergency department-based registry were retrospectively evaluated. Patients with non-traumatic and noncommunicable diseases on initial presentation and with Glasgow Comal Scale scores of < 15 were included in the study.RESULTS:
Among the 367 brain CT results of patients with AMS during the study period, 146 (39.8%) were positive. In a multivariate analysis, the presence of focal neurologic deficit (odds ratio [OR], 132.6; 95% confidence interval [CI], 37.8 to 464.6), C-reactive protein level < 2 mg/dL (OR, 3.9; 95% CI, 1.4 to 10.6), and Glasgow Comal Scale score < 9 (OR, 2.4; 95% CI, 1.2 to 4.8) were significantly associated with positive brain CT results.CONCLUSION:
The presence of focal neurologic deficit, initial Glasgow Comal Scale score of < 9, and initial C-reactive protein levels of < 2 mg/dL can facilitate the selection of brain CT to diagnose patients with acute AMS in the emergency department.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Unconsciousness
/
Brain
/
C-Reactive Protein
/
Tomography, X-Ray Computed
/
Multivariate Analysis
/
Retrospective Studies
/
Risk Factors
/
Diagnosis
/
Emergencies
/
Emergency Service, Hospital
Type of study:
Diagnostic study
/
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Clinical and Experimental Emergency Medicine
Year:
2018
Type:
Article
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